⚠️ Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. If you are experiencing symptoms described in this article — especially severe headaches, rapid heartbeat, or dangerously high blood pressure — seek medical evaluation promptly.
Key Takeaways
- Pheochromocytoma (“pheo”) is a rare tumor of the adrenal gland that produces excess adrenaline-like hormones
- It’s called the “great mimic” because symptoms overlap with many common conditions
- The classic triad — headaches, sweating, and rapid heartbeat — occurs in many but not all patients
- Episodic symptoms (coming and going) are a key clue that often gets overlooked
- Diagnosis requires specific hormone testing and imaging
You’ve been to doctor after doctor. Your blood pressure swings wildly. You have episodes of pounding headaches, drenching sweats, and a racing heart that come out of nowhere.
You’ve been told it’s anxiety. Panic attacks. Stress. But something doesn’t add up.
If this sounds familiar, you might want to ask your doctor about pheochromocytoma — a rare but treatable tumor that’s notorious for being missed.
“Pheochromocytoma is one of those conditions where patients often know something is wrong long before they get diagnosed,” says Julia Kravtsova, PharmD, Head Patient Navigator at QuickRx Specialty Pharmacy.
What is Pheochromocytoma?
Pheochromocytoma (fee-oh-kro-mo-sy-TOE-muh) — often shortened to “pheo” — is a rare tumor that usually arises in the adrenal glands.
- What it does: Produces excess catecholamines — hormones like adrenaline
- How common: Estimated 2-8 cases per million people per year
- Who gets it: Can occur at any age, peak incidence in 40s-50s
- Malignancy: Most are benign, but 10-15% may be malignant
The Classic Symptom Triad
1. Headaches
Often severe and pounding, may come on suddenly during episodes.
2. Sweating
Profuse, drenching sweats even in cool environments.
3. Rapid Heartbeat (Tachycardia)
Heart racing or pounding, may feel like your heart is beating out of your chest.
Other Common Symptoms
- Severe hypertension: Blood pressure may spike to dangerous levels
- Episodic hypertension: Blood pressure normal between attacks — a key clue
- Resistant hypertension: High blood pressure that doesn’t respond to typical medications
- Anxiety, nervousness, or sense of doom
- Tremor
- Pallor (pale skin) during episodes
- Nausea or abdominal pain
- Weight loss
Why It’s Called the “Great Mimic”
Pheochromocytoma symptoms overlap with many conditions:
- Panic disorder / anxiety
- Essential hypertension
- Hyperthyroidism
- Menopause
- Cardiac arrhythmias
- Migraine
Why Diagnosis Takes So Long
- Pheo is rare — doctors may not think of it
- Symptoms are common complaints
- Episodes may not occur during appointments
- Standard blood pressure medications may partially help
Red Flags That Should Trigger Testing
- Hypertension with episodic symptoms
- Hypertension in young patients
- Resistant hypertension
- Blood pressure spikes triggered by anesthesia or certain medications
- Adrenal mass found on imaging
- Family history of pheo or related genetic syndromes
How to Get Properly Diagnosed
The Right Tests
- Plasma free metanephrines: Best initial screening test
- 24-hour urine catecholamines and metanephrines
- CT or MRI of adrenals: To locate the tumor
- Functional imaging: MIBG scan or PET scan
Advocating for Yourself
- Document your episodes
- Ask specifically about pheo testing
- See an endocrinologist
- Don’t give up if told it’s “just anxiety”
The Genetic Connection
Up to 40% of pheo cases have a genetic component. Genetic testing is increasingly recommended for all patients.
After Diagnosis: What’s Next
Medical Preparation
Before surgery, patients need medication to block catecholamine effects, including alpha-blockers, beta-blockers, and sometimes metyrosine (Demser).
Surgery
Surgical removal is the definitive treatment for most patients.
Need Help Affording Pheochromocytoma Treatment?
QuickRx Specialty Pharmacy can help with copay assistance for medications like Demser (metyrosine).
📞 Call (917) 830-2525 or (800) 496-6111
Frequently Asked Questions
How rare is pheochromocytoma?
Very rare — estimated at 2-8 cases per million people per year.
Can pheochromocytoma be cured?
In most cases, yes. Surgical removal of a benign pheo is typically curative, though lifelong follow-up is recommended.
Is pheochromocytoma cancer?
Most (85-90%) are benign. However, 10-15% are malignant.
Can anxiety cause the same symptoms?
Yes, but pheo episodes typically include severely elevated blood pressure, which panic attacks usually don’t.
What kind of doctor diagnoses pheochromocytoma?
Endocrinologists are most familiar with diagnosing and managing pheochromocytoma.
Written By: Paola Larrabure, Pharma Content Manager, QuickRx Specialty Pharmacy
Reviewed By: Julia Kravtsova, PharmD, Head Patient Navigator, QuickRx Specialty Pharmacy
Last Updated: February 2026
