PHEOCHROMOCYTOMA-NEUROBLASTOMA

Pheochromocytoma is a tumor of the adrenal medulla; generally arise from chromaffin cells (Brown & Brown, 2008), which cause hypersecretion of catecholamine. Patient tends to experience sudden spell of elevated blood pressure, palpitations, headache, diaphoresis, and anxiety. The diagnosis is made by demonstration of elevated urinary levels of catecholamine metabolites. Pharmacologically, this disorder is managed with nonselective α-antagonists such as Phenoxybenzamine and Phentolamine.

Phenoxybenzamine (Le, Bhushan, Tolles, & Hofmann, 2011) is an irreversible, nonselective agent with a longer duration of action than Phentolamine, and is used preferentially for treatment until the patient can be taken to the operating room to have the mass resected.

It also is useful to keep in mind that Pheochromocytoma is a part of multiple endocrine neoplasia (MEN) type II (medullary carcinoma of the thyroid, pheochromocytoma, and parathyroid tumor) and MEN type III (medullary carcinoma of the thyroid, pheochromocytoma, and mucosal neuroma), also are associated with von Hippel Lindau disease, and neurofibromatosis according Brown & Brown (2008).

Neuroblastoma is the most common intra-abdominal malignancy of infancy and the most common extra-cranial solid tumor of childhood, preceded by leukemias, CNS tumors, and lymphomas according of Joyner (2010).

 The first symptoms are fever, malaise, and pain; vary depending on what part of the body is affected. In the abdomen, the most common form, may present with abdominal pain, change in bowel habits, swelling in the leg, and a mass under skin that isn’t tender when touched.  It also shows increased urinary levels of catecholamine metabolites, this neuroendocrine tumor arise from neural crest cells (Brown & Browns, 2008), and It is one of the small, blue, round cell tumors of childhood (Joyner, 2010).

The treatment for Neuroblastoma dependent for a multiples condition such as age, stage of evolution, biologic risk factors based on the International Neuroblastoma Staging, in turn to determines the intensity of therapy (Lacayo, 2010).

Bibliography

Brown, T. A., & Brown, D. D. (2008). USMLE step 1 Secrets. Mosby Elsevier.

Joyner, B. D. (2010, Dec 3). medscape.com. Retrieved may 9, 2012, from Neuroblastoma: http://emedicine.medscape.com/article/439263-overview

Lacayo, N. J. (2010, oct 20). madscape.com. Retrieved may 9, 2012, from Pediatric Neuroblastoma treatment and management: http://www.emedice.medscape.com/article/988284-treatment#a1127

Le, T., Bhushan, V., Tolles, J., & Hofmann, J. (2011). First AID for the USMLE step 1. usa: McGraw Hill.