Clinical Manifestations

Abstract

The clinical manifestations encountered in patients with pheochromocytoma consist of such a large variety of symptoms and signs that they have been described as kaleidoscopic. The pleomorphism of the disease has been emphasized and about 80 manifestations have been reported (215, pp. 105, 106; 437, p. 83). Often symptoms caused by this endocrinopathy occur in a dramatic and explosive fashion when the tumor suddenly releases catecholamines into the circulation. On rare occasions sudden death may occur with the initial attack in a patient with pheochromocytoma who has previously been asymptomatic (984). Also, on rare occasions, patients may present with clinical manifestations of one of the complications of these tumors. An abrupt onset of complaints is extremely common during an episode of paroxysmal hypertension. Rarely, there may be a premonition that an attack is about to occur (927). About 50 percent of patients with persistent hypertension experience a sudden onset of symptoms usually associated with episodic increases in the hypertension; however, in patients with sustained hypertension, symptoms are generally less pronounced than in patients with paroxysmal hypertension.