Usually, the adrenal gland is found in people older than 25 years, so pheochromocytoma in children is considered a rare phenomenon, and most often in this case, the neoplasm in the child has a genetic origin. This disease often affects boys, rather than girls.
Suspicion of a tumor of the adrenal glands in children occurs in the case of high blood pressure. However, if this symptom is not permanent, then the increase can be carried out gradually or paroxysmally, until it reaches high figures. Often such children complain of headache and general poor health, and when examined, excessive sweating, glucosuria and changes in the fundus can be seen.
But to say that it was the pheochromocytoma that caused the increase in pressure is impossible, unless other diseases affecting BP are excluded. To clarify the diagnosis, urine samples with the content of catecholamines in them may be indicative, as well as a reaction to a reginal sample that will indicate a pheochromocytoma if the blood pressure drops by 30-40 mm Hg after the injection.
In order to cure the child, it is necessary to perform an operation to remove the tumor. First you need to establish the amount, size and location of the tumor. Then they begin preparatory preoperative work aimed at increasing the chances of a positive outcome of the operation. First, you need to normalize the pressure with intravenous injections, and also make sure that there are no violent disorders of carbohydrate metabolism and, if necessary, assign a dose of insulin appropriate to his body. For children with pheochromocytoma, it is very important to get adequate nutrition, which will contain the necessary vitamins in the right amount.
Operations for children under general anesthesia, but the process of introducing anesthesia requires an anesthesiologist a lot of experience and attention, as the blood pressure and pulse of a child change very quickly depending on the stage of the operation. During the introduction of anesthesia, the hemodynamics of small patients are monitored every 2 minutes. No less attention is required from the surgeon, especially at the time of palpation and separation of the tumor, because excessive pressure on the pheochromocytoma can dramatically increase the pressure to dangerous for children.
If the removal of the tumor is successful, then the pressure is usually normalized by the end of the operation, the continuation of the same blood pressure may indicate that the tumor was not completely removed.
After the operation, children are required to prescribe exercise therapy for the prevention of pulmonary complications, and in case the pheochromocytoma was benign, periodic examinations are recommended for an endocrinologist for 1 year. If the tumor was cancerous, then follow-up should last up to 5 years.
The main complications of pheochromocytoma in children is the destruction of the vessels of the heart, kidneys and the fundus. As a rule, they gradually disappear after removal of the tumor, but if the diagnosis was late or the pressure fluctuations turned out to be very high, the retinal disorders can be persistent and not recoverable, thereby worsening the child's vision or leading to complete blindness. Such visual impairments lead to the fact that the child will need to undergo training in a special school, and further take into account some restrictions in the choice of profession.