Most high blood pressure develops slowly from a mix of factors with no single clear cause. But sometimes it comes from a specific problem in one organ. High blood pressure with an identifiable cause is called secondary hypertension. One such cause is a pheochromocytoma, a tumor that arises in the adrenal gland — a small hormone-producing organ that sits like a cap on top of each kidney.
A pheochromocytoma forms in the inner part of the adrenal gland and releases more 'catecholamine' hormones — such as adrenaline — than the body needs. Because these hormones push the body into a state of alarm, the condition is known for causing headache, heavy sweating, and a pounding heartbeat together. Flushing, cold sweats, paleness, and unexplained anxiety may accompany them.
A common source of confusion is: why suspect a pheochromocytoma when the blood pressure reads normal? This tumor often releases hormones in bursts rather than steadily. So between episodes the pressure may read a normal 120/80, then suddenly spike again and again. That is why a few normal readings at home are not enough to rule it out.
Diagnosis is not made from symptoms alone. Doctors usually measure 'metanephrines' — breakdown products of catecholamines — in the blood and urine, and often collect a 24-hour urine sample to see how much hormone is released over a full day. Imaging such as CT or MRI is then used to check whether a tumor is actually present in the adrenal gland. Because the hormone results and the imaging must be read together, it commonly takes several days to a few weeks to reach a conclusion.
The waiting period can be the hardest part. Because the diagnosis is not yet confirmed, medication may be held for a time. Rather than starting or stopping a drug on your own, it is safer to ask your care team in advance what to do when symptoms flare and which situations call for an emergency visit. Sudden, severe symptoms — an unbearable headache, chest pain, extreme palpitations, or new visual disturbance — should be reported to a medical facility right away rather than waiting for results.
The reassuring part is that most pheochromocytomas are benign, and when accurately diagnosed they can often be well managed with treatment, including surgery. Still, every situation differs, and the same symptoms can stem from causes other than a pheochromocytoma, so the diagnosis and treatment plan should be decided together with your care team based on the test results.
This article is general information and does not replace individual medical care. Any judgment about your symptoms or test results, or whether to take a medication, should be discussed with your own doctor.