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Tests and diagnosis
By Mayo Clinic staffYour doctor will likely conduct a number of tests to determine if a pheochromocytoma is the cause of your signs and symptoms. These may include:
- Blood and urine tests. These tests can reveal elevated levels of the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine) and their breakdown products (metanephrines). You may need to collect urine samples over a 24-hour period for testing. If the results of these tests indicate a pheochromocytoma, the next step is to determine the location of the tumor.
- Scans. A computerized tomography (CT) scan of your abdomen can detect the tumor in most cases. However, it may be necessary to scan other areas of your body, such as your neck, chest and pelvis. Scanning with other diagnostic imaging techniques, such as magnetic resonance imaging (MRI) or an m-iodobenzylguanidine (MIBG) scan, may be done to detect the tumor.
Incidental discovery
Some adrenal gland tumors are discovered incidentally during imaging studies conducted for other reasons. For example, you might see your doctor because of abdominal pain, and a CT scan may reveal a mass on one of your adrenal glands. A small percentage of adrenal gland tumors found incidentally are pheochromocytomas, even when no signs or symptoms are present.
If you have an adrenal mass found incidentally, your doctor will obtain blood and urine tests to see if there's hormone overproduction. The vast number of small adrenal gland tumors are not pheochromocytomas, and are noncancerous (benign), requiring only observation and no treatment.
Genetic testing
Genetic mutations may be responsible for pheochromocytoma and paraganglioma, and your doctor may suggest genetic testing. However, whether you need genetic testing and, if so, which type depends on the location of your tumor and related medical conditions. If you have a history of pheochromocytoma or an associated disease, seek genetic counseling to help you decide if you should undergo genetic testing.
- Neumann HP. Pheochromocytoma. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2902847. Accessed Feb. 20, 2009.
- Young WF, et al. Clinical presentation and diagnosis of pheochromocytoma. http://www.uptodate.com/home/index.html. Accessed Feb. 20, 2009.
- Fitzgerald PA. Endocrine disorders. In: McPhee SJ. Current Medical Diagnosis & Treatment. Los Altos, Calif.: Lange Medical Publications. 2009. http://www.accessmedicine.com/content.aspx?aID=14198. Accessed Feb. 20, 2009.
- Pheochromocytoma and paraganglioma. In: Kronenberg HM, et al. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/121640013-2/0/1555/94.html. Accessed Feb. 20, 2009.
- Hebert CJ, et al. Hypertensive crises. Primary Care. 2008;35:475. Accessed Feb. 21, 2009.
