Phaeochromocytoma

The name of this tumour is related to the description of its appearance when analysed the laboratory. The tumour develops from the inner part of the adrenal gland (the medulla) and produces excess amounts of hormones related to adrenaline. When such a tumour develops outside the adrenal glands it is called a paraganglioma.

A review in British Medical Journal few years ago quoted that the average GP will see only one such patients during an entire career. In this context is not surprising that many patients are not diagnosed for several years until the combination of symptoms becomes apparent to a clinician who initiates the correct tests to demonstrate the diagnosis.

Over the last two decades Oxford has accumulated the largest cohort of patients operated in a single centre. The role of a multidisciplinary team cannot be over emphasised :

• the endocrinology team ensures a timely diagnosis, initiates the appropriate medication, coordinates the genetic tests and provides the long-term follow-up

• the radiology colleagues provide most up-to-date imaging to provide a full ‘map’ before the operation

• one Consultant Anaesthetist has looked after all these patients and by now is the most experienced anaesthetist to be involved in the care of such patients

• the pathology colleagues will analyse the tumour after the operation to demonstrate whether or not there are any concerns of its behaviour being more aggressive