<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> rare catecholamine secreting tumour. 10% are familial and may be associated with MEN type II, neurofibromatosis and von Hippel-Lindau syndrome ''Basics'' bilateral in 10% malignant in 10% extra-adrenal in 10% (most common site = organ of Zuckerkandl, adjacent to the bifurcation of the aorta) ''Features are typically episodic'' hypertension (around 90% of cases, may be sustatined) headaches palpitations sweating anxiety ''Tests'' 24 hr urinary collection of metanephrines (sensitivity 97%*) this has replaced a 24 hr urinary collection of catecholamines (sensitivity 86%) Surgery is the definitive management. The patient must first however be stabilized with medical management: alpha-blocker (e.g. phenoxybenzamine), given before a beta-blocker (e.g. propranolol)