Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with classic triad of episodic headaches, diaphoresis, and tachycardia. Reports paroxysmal hypertension, palpitations, and anxiety/tremulousness. Denies recent medication changes or illicit substance use. Symptoms are triggered by physical exertion or stress.
Clinical Examination Findings
Vitals: Significant paroxysmal hypertension noted. HEENT: No thyromegaly. CV: Tachycardia, regular rhythm, no murmurs. Lungs: Clear to auscultation bilaterally. Abdomen: Soft, non-tender, no palpable masses or bruits. Skin: Diaphoretic, no café-au-lait spots or neurofibromas noted.
Treatment Protocol
Preoperative alpha-adrenergic blockade (e.g., Phenoxybenzamine) initiated for 10-14 days to control blood pressure and expand intravascular volume. Beta-blockade added only after adequate alpha-blockade to prevent hypertensive crisis. Surgical plan: Adrenalectomy (laparoscopic vs. open) pending tumor size and location.