Clinical expressions of pheochromocytoma result from effects of excess catecholamines, which these tumors release directly into the circulation. Manifestations, often dramatic and explosive, are so variable that pheochromocytoma has rightly earned the title "the great mimic."1 The importance of a careful and detailed history cannot be overemphasized since about 95% of patients with pheochromocytomas will have one or more of the following: headaches (often severe and throbbing), hyperhidrosis (usually generalized), and palpitations. (An exception to this statement are patients with familial pheochromocytoma, who make up about 10% of patients harboring the tumor; they may have relatively few, if any, manifestations of excess circulating catecholamines.2)
Experience indicates that anxiety, with or without fear of impending death and sometimes even "panic" (ie, severe apprehension), is the fourth most common symptom encountered, occurring in 60% and 28% of those with paroxysmal and persistent hypertension, respectively.2 Since anxiety is associated
Manager WM. Psychiatric Manifestations in Patients With Pheochromocytomas. Arch Intern Med. 1985;145(2):229–230. doi:10.1001/archinte.1985.00360020049006
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