5th April 2024

Management

Management is based around medically treating the effects of the tumour, particularly hypertension, followed by surgical resection. Some patients may present in hypertensive crises (SBP >250 mmHg) and will require urgent admission and medical management to reduce their blood pressure. This is usually achieved using phentolamine or nitroprusside.

Prior to surgery, steps must be taken to suppress the sympathetic system and stop the patient going into a hypertensive crisis. This is achieved through alpha blockers e.g., phenoxybenzamine or doxazosin, and then beta blockers if needed. Surgical excision of the affected adrenal gland is the main approach and is curative in 85% of cases. In the rare cases of malignant phaeochromocytoma, treatment is based around surgery followed by chemotherapy.