Wi go tɔk bɔt di rare tumor we dɛn kɔl Pheochromocytoma tide?

Sɔntɛnde, yu kin gɛt ay blɔd prɛshɔn wantɛm wantɛm? Ɔ yu jɔs de swet? Yu kin gɛt ed pen wit at we de bit? Nɔr kwik fɔ tink se sɔm pan dɛn tin ya na siriɔs sik. Bɔt if dɛn sik ya kɔntinyu, mɔ wit ay blɔd prɛshɔn we at fɔ kɔntrol, i go fayn fɔ mek yu wɔri smɔl. Tide wi go tɔk bɔt wan sik we nɔ kin apin smɔl, bɔt if dɛn no am fayn, dɛn kin trit am fayn fayn wan. Dɛn kɔl dat fiokromocytoma.

Wetin na Fiokromosaytoma? Lɛ wi ɔndastand am simpul wan.

Fɔ tɔk am simpul wan, fiochromocytoma na wan tכmכro we de divεlכp na di midul pat pan di adrenal gland dεm, we na di adrenal mεdula. dis tכmכro dεm de fכm bay wan spεshal kayn sεl we dεn kכl kromafin sεl dεm. dis sεl dεm de prodyuz εn rilis כmon dεm na di bכdi we nid fכ wi bכdi in "fεt כ fכ flay" rεspכns. Tink bɔt am, we yu de fred wantɛm wantɛm ɔ yu de gɛt bɔku strɛs, di chenj dɛn we de apin na yu bɔdi - yu at rit de go ɔp, yu de swet, yu bɔdi de shek - na dɛn ɔmon ya de ripɔtabl fɔ dis.

di fiokromosaytoma kin divεlכp na wan adrenal gland nכmכ. Bɔt sɔntɛnde i kin kam na di tu gland dɛn. I pɔsibul fɔ gɛt mɔ pas wan tumbu na wan gland.

di imכtant tin na dat, mכst fiokromosaytoma dεm na benign (nכto malignant) . Dis min se dɛn nɔ de skata to ɔda pat dɛn na di bɔdi. Bɔt bitwin 10% ɛn 15% kin gɛt kansa. If dis na kansa, dɛn kin tɔk bɔt am insay sɔm men kategori dɛm, i kin dipen pan aw i dɔn skata:

• lokalizεd fכkromosaytoma: di tכmכro de insay wan כ tu adrenal gland dεm nכmכ.
• Rijinal fiokromosaytoma: Di kansa dɔn spre to di limf no dɛm nia di adrenal gland dɛm ɔ to ɔda tisu dɛm.
• Metastatic pheochromocytoma: Di kansa dɔn spre to di ɔgan dɛm we de fa lɛk di liva, di lɔng, ɔ di bon dɛm.
• Rikɔrɛnt fiokromosaytɔma: Di kansa dɔn kam bak afta dɛn dɔn trit am. I kin de na di sem ples we i bin de bifo ɔ na difrɛn ples.

Wetin na dɛn adrenal gland ya na wi bɔdi? Wetin na dɛn wok?

Wi gɛt tu adrenal gland dɛn. Dɛn de na di bak pat na wi bɛlɛ, ɔp wi kidni, lɛk kap. Dɛn na pat pan wi ɛndokrin sistɛm. Ɛni adrenal gland gɛt tu men pat dɛn. di layt we de na do dεn kכl am di adrenal kכtεks, εn di midul pat dεn kכl am di adrenal mεdula.

wi adrenal mεdula de mek wan grup כmon dεm we dεn kכl katekolamin. Dɛn ɔmon ya de kɔntrol sɔm rili impɔtant tin dɛn we de apin na wi bɔdi:

• At rit we yu de bit
• Blɔd prɛshɔn
• Blɔd shuga lɛvɛl `(Blɔd glukɔs)`
• Aw wi bɔdi de ansa to strɛs (di "fayt ɔ flay" rispɔns) .

di men kayn katekolamin dεm na:

• Dopamin we dɛn kɔl Dopamin
• Epinefrin (Adrenaline) `(Epinefrin / Adrenalin)`
• Norepinephrin (Noradrenaline) `(Nɔrepinefrin / Nɔradrenalin)`

we fiochromocytoma de, i kin rilis mכr pan dεn כmon dεm ya, adrenaline εn noradrenaline, insay di bכdi pas aw i nid. Na da tɛm de difrɛn sayn dɛn kin bigin fɔ sho.

Wetin na di difrɛns bitwin Pheochromocytoma ɛn Paraganglioma?

Dis na tu kayn tumbu dɛn we rili fiba, we nɔ kin bɔku. Dɛn tu de kɔmɔt frɔm di sem kromafin sɛl dɛn we wi bin dɔn tɔk bɔt. כltu, fiokromosaytoma de kכmכt na di midul pat pan di adrenal gland (di adrenal mεdula), we paraganglioma de kכmכt na כda ples dεm we de ausayd di adrenal gland .

Udat kin gɛt dis sik pas ɔlman? Aw i kɔmɔn?

Fiokromocytoma kin divεlכp pan eni ej, bכt i kin kכmכn pan pipul dεm we ol bitwin 30 εn 50. lεk 10% pan di kes dεm dεn kin ripot we dεn sכm pikin.

Dis na wan tumbu we nɔ kin apin so ɔltɛm . E nɔr kin izi fɔ tɔk ɔmɔs pipul dɛn gɛt dis sik. Bikɔs sɔm pipul dɛn nɔ kin sho ɛni sayn, dɛn nɔ kin no bɔt dis sik. Dɛn se less dan 1% pan di pipul dɛm wae gɛt ay blɔd prɛshɔn gɛt fiochromocytoma.

Us sayn dɛm pɔrsin wae gɛt fiochromocytoma kin sho?

di fiokromosaytoma simptom dεm kin apin we di tכmכro de rilis tu mכch כmon dεm we dεn kכl adrenaline (epinephrine) כ noradrenaline (norepinephrine) insay di bכdi. Bɔt sɔm tumbu dɛn nɔ kin mek bɔku pan dɛn ɔmon ya ɛn dɛn nɔ kin gɛt ɛni sayn.

De sayn dɛm wae dɛn kin si mɔr na:

• Ay blɔd prɛshɔn (Hypertension): Dis na di men sayn. Sɔntɛnde, i nɔ kin izi fɔ kɔntrol am.
• Ɛd we de at: I kin bi wan bad bad ed we de at wantɛm wantɛm.
• Fɔ swet pasmak fɔ natin.
• Palpitations na filin wae de hat bit kwik kwik wan, nɔr de bit ɔltɛm, ɔr de bit.
• Fɔ fil lɛk se yu bɔdi de shek.

Di sayn dɛm we nɔ kin bɔku:

• Chɛst ɛn/ɔ bɛlɛ pen.
• Di skin kin bi paler wantɛm wantɛm pas aw i kin bi.
• Nɔs ɛn/ɔ vɔmit.
• Rɔnbɛlɛ.
• Banbɛlɛ.
• Ɔtostatik haypɔtɛnshɔn na we yu blɔd prɛshɔn go dɔŋ wantɛm wantɛm we yu tinap. Dis min se yu kin fil diziz we yu tinap wantɛm wantɛm we yu sidɔm.
• We yu de lɔs yu wet fɔ natin.

Dɛn sayn ya kin apin ɔr kin wɔs afta sɔm tin wae apin. Fɔ ɛgzampul:

• Intɛns fyzikal aktiviti.
• Injury na yu bɔdi ɔr yu maynd strɛs bad bad wan.
• Fɔ bɔn pikin.
• Fɔ gɛt anestezi.
• Fɔ du ɔpreshɔn.
• Fɔ it it dɛn we gɛt bɔku tayramin (e.g. rɛd wayn, chɔklɛt, chiz).

Yu tink se di sayn dɛn kin de ɔltɛm? Ɔ dɛn kin kam ɛn go?

Pɔsin we gɛt fiochromocytoma kin gɛt ay blɔd prɛshɔn we nɔ de dɔn, ɔ i kin kam ɛn go .

Sɔm pipul dɛn kin gɛt "paroxysmal attacks," ɔr dɛn kin gɛt sɔm kayn sik dɛn we dɛn kin gɛt wantɛm wantɛm. Dis min se di blɔd prɛshɔn kin go ɔp wantɛm wantɛm, we kin kam wit sɔm sayn dɛn lɛk we yu ed kin at bad bad wan, yu at kin bit, ɛn yu kin swet pasmak. Dɛn "atak" ya kin apin bɔku tɛm insay di de, ɔ ivin wan ɔ tu tɛm insay di mɔnt.

Impɔtant: If yu gɛt ɛni wan pan dɛn sik ya, mɔ we yu gɛt ay blɔd prɛshɔn wantɛm wantɛm, ed we de at, we yu de swet, ɛn we yu de blo, i rili impɔtant fɔ go to dɔktɔ.

Wetin mek di fiochromocytoma de divεlכp? Wetin na di tin dɛn we kin mek i apin?

כl di kes dεm, dεn nכ kin fכnshכn n כ spεshal kכz fכ fiokromosaytכma. I kin apin randomly.

כltu, insay 25% to 35% pan di kes dεm, dis kכndyushכn de riliyt to di kכndishכn dεm we dεn kin gεt fכ bכn. Sɔm pan di men wan dɛn na:

• mכltipכl εndokrin niכplasia 2 sεndrכm, tayp A εn B (MEN2A εn MEN2B) .
• Von Hippel-Lindau (VHL) sik we dɛn kɔl di sik
• Nyurofibromatosis tayp 1 (NF1) .
• Sindrom we dɛn kɔl paraganglioma we dɛn kin gɛt frɔm dɛn mama ɛn papa
• Carney-Stratakis dyad [paraganglioma ɛn gεstrointestinal stromal tכmכro (GIST)].
• Carney triad (paraganglioma, GIST ɛn pulmonari kɔndrɔma) .

apat frכm dεn jεnεtik kכndishכn dεm ya, fiokromosaytכma kin divεlכp bak bikoz fכ mכtεshכn dεm na atכs 10 difrεn jin dεm.

Aw dɛn kin no dis sik? (Diagnosis) .

Fiochromocytoma kin tranga fɔ no bikɔs na wan tumbu we nɔ kin bɔku ɛn sɔntɛnde i nɔ kin mek yu gɛt ɛni sayn. Sɔntɛnde, dɛn kin no di tumbu bay we dɛn de du tɛst fɔ ɔda rizin.

Bɔku rizin dɛn de we mek dɔktɔ kin tink se dis sik de:

• Na yu yonWan ditayl mɛdikal histri, mɔ if ɛnibɔdi na di famili dɔn gɛt fiochromocytoma bifo.
• Wan kɔmplit ɛgzam fɔ bɔdi ɛn mɛrɛsin.
• Sɔm patikyula simptom dɛm , fɔ ɛgzampul di "paroxysmal attacks" we wi bin tɔk bɔt ɛn di ay blɔd prɛshɔn we nɔmal tritmɛnt nɔ kin kɔntrol.

Us kayn tɛst dɛn kin du?

Yu dɔktɔ kin tɛl yu fɔ du dɛn tɛst ya fɔ no if yu gɛt fiochromocytoma:

• 24 awa urine test: Dis involv fɔ gɛda yu urine ɔl di de ɛn mɛzhɔ di amount of catecholamines insay. I de mɛzhɔ bak di tin dɛn we dɛn kin mek we dɛn ɔmon dɛn ya brok. if dεn lεvεl dεm ya hכy pas nכmal, i kin bi sayn fכ fiokromosaytoma.
• Blɔd katekolamin tɛst: Dɛn wan ya de mɛzhɔ di lɛvɛl we di katekolamin de na di blɔd. Lɛk urine test, dɛn kin luk bak fɔ tin dɛn we dɛn kin mek we di ɔmon dɛn brok.
• CT scan (Computer Tomography scan): Dis kin tek sɔm X-ray fɔ mek ditayli pikchɔ dɛn bɔt di insay pat na yu bɔdi. Yu dɔktɔ kin tɛl yu fɔ du dis fɔ luk yu adrenal gland dɛn.
• MRI skan (MRI - Magnetic Resonance Imaging): Dis kin yuz magnet, redio wev, ɛn kɔmpyuta fɔ mek ditayli pikchɔ dɛn bɔt di insay pat na di bɔdi. Dɛn kin yuz am bak fɔ chɛk di adrenal gland dɛn.

We dɛn dɔn kɔnfirm di sik, dɛn kin du ɔda tɛst fɔ no if di tumbu gɛt kansa (malignant) ɔ benign (benign), ɛn if i dɔn spre to ɔda pat dɛn na di bɔdi.

Wetin mek I Impɔtant fɔ Tɛst di Jɛnɛtiks?

If dɛn no se yu gɛt fiochromocytoma, yu dɔktɔ go tɛl yu fɔ advays yu bɔt yu jɛnɛtiks ɛn tɛst yu fɔ no if yu gɛt wan sik we yu gɛt frɔm yu mama ɛn papa we de put yu pan denja fɔ gɛt ɔda kansa.

Dɛn kin se dɛn fɔ tɛst di jɛnɛtiks pan kes dɛn lɛk dɛn wan ya:

• If yu ɔ sɔmbɔdi na yu famili gɛt sɔm kayn sik wae gɛt fɔ du wit hereditary pheochromocytoma ɔ paraganglioma syndrome.
• If yu gɛt tumbu na yu tu adrenal gland dɛn.
• If pas wan tumbu de na wan adrenal gland.
• If sɔm sayn dɛn de we de sho se di katekolamin dɛn we de na di blɔd go ɔp.
• if dεn no fכ fכkromosaytכma bifo i rich 40 ia.

If di jenɛtik tɛst si se di jin chenj, di jenɛtik advaysa kin tɛl ɔda pipul dɛn na yu famili (dɛn wan we nɔ gɛt ɛni sayn bɔt we de pan denja) bak fɔ du dis tɛst.

Wetin na di tritmɛnt dɛm fɔ Pheochromocytoma?

Di bɛst tritmɛnt fɔ dis na fɔ ɔpreshɔn fɔ pul di tumbu, if i pɔsibul .

Di tritmɛnt we dɛn kin pik kin dipen pan bɔku tin dɛn:

• Di saiz fɔ di tumbu.
• If di tumbu gɛt kansa (malignant) ɔ benign (benign).
• If sɔm sayn dɛn de bikɔs ɔf di inkris na di katekolamin ɔmon.
• Yu tink se na wan say nɔmɔ di tumbu de, ɔ i dɔn skata to ɔda pat dɛn na di bɔdi? (Dɛn dɔn mɛtastas) .
• If dɛn bin no di sik fɔ di fɔs tɛm, ɔ if i dɔn kam bak afta dɛn dɔn trit am bifo.

If yu gɛt sɔm sayn dɛn bikɔs ɔf di adrenal ɔmon dɛn we de bɔku, yu dɔktɔ kin gi yu mɛrɛsin fɔ kɔntrol dɛn sik dɛn de. Fɔ ɛgzampul:

• Mɛrɛsin fɔ kip blɔd prɛshɔn na nɔmal lɛvɛl, lɛk alfa-blɔk.
• Mεdikeshכn dεm fכ kip di at rεt na nכmal lεvεl, lεk beta-blכk dεm.
• Mεdikeshכn dεm we de blכk di ifekt dεm fכ di כmon dεm we di adrenal gland de kכmכt pasmak.

di men tritmεnt opshכn dεm fכ fiokromosaytכma na:

• Ɔpreshɔn
• Redyushɔn tɛrapi
• Kimotɛrapi
• Ablashɔn tɛrapi
• Embolizayshɔn tɛrapi
• Targeted therapy

Yu ɛn yu mɛdikal tim go disayd di tritmɛnt plan we go fayn fɔ yu.

Men tritmɛnt we dɛn kin yuz

• Ɔpreshɔn:

Dis na di men tritmɛnt fɔ fiochromocytoma. lεk 90% pan di tכmכro dεm kin kכmכt fayn fayn wan wit כpεrayshכn .

Yu dɔktɔ kin tɛl yu fɔ du ɔpreshɔn fɔ pul wan ɔ ɔl tu di adrenal gland dɛn (adrenalectomy). We dɛn de du di ɔpreshɔn, di dɔktɔ we de du di ɔpreshɔn go chɛk di tisu ɛn di limf no dɛn we de rawnd am fɔ si if di tumbu dɔn skata. If i dɔn, dɛn go pul da tisu de, if i pɔsibul.

Afta dɛn dɔn du di ɔpreshɔn, dɛn go tɛst yu blɔd ɔ yu urine fɔ si if di katekolamin lɛvɛl de. if di lεvεl dεm go bak to nכmal, i min se dεn dכn pul כl di fiokromosaytכma sεl dεm.

If dɛn pul ɔl tu di adrenal gland dɛn, yu go gɛt fɔ tek ɔmon tɛrapi fɔ di res ɔf yu layf fɔ tek di ɔmon dɛn we di adrenal gland dɛn de mek.

• Redyushɔn tɛrapi: .

Dis na tritmɛnt we dɛn kin yuz fɔ kil di kansa sɛl dɛn ɔ fɔ stɔp dɛn fɔ gro. Dɛn kin du dis di kayn we we nɔ go ambɔg di wɛlbɔdi tisu dɛn as i pɔsibul.

Tu kayn we dɛn de fɔ mɛn pipul dɛn we gɛt raytin:

• Ekstanshal raytin tɛrapi: Dɛn kin kɛr di raytin go na di say we di kansa de frɔm wan mashin we de na do na di bɔdi.
• Intanɛt raytin tɛrapi: Dɛn kin pak wan redioaktiv tin insay nidul, sid, waya, ɔ kateshɔn ɛn dɔktɔ kin put am insay ɔ nia di say we di kansa de.

Di kayn rεdyushכn tεrapi dipכnt pan if di kεnsar de na di say we i de, rεjכnal, mεtastas, כ i de kam bak. di malignant fiokromosaytoma kin trit am mכst wit εksternal bim rεdyushכn tεrapi εn/כ 131I-MIBG tεrapi. 131I-MIBG na redioaktiv tin we de atak sכm kεnsar sεl dεm εn kil dεm.

• Kimotɛrapi: .

Dis kin yuz drɔgs fɔ kil di kansa sɛl dɛm, stɔp dɛn fɔ sheb ɛn bɔku, ɔ stɔp di kansa fɔ gro. Dɛn kin gi dɛn mɛrɛsin ya insay di bɛlɛ. Pan ɔl we dis na tritmɛnt we kin wok fayn, i kin gɛt bad bad tin dɛn fɔ du.

• Ablashɔn tɛrapi: .

Dis na tritmɛnt we nɔ kin tek bɔku pipul dɛn. I de yuz ɔt pasmak ɔ kol pasmak fɔ pwɛl di tumbu dɛn.

• Rediofrikyuɛnsi ablashɔn: Rediofrikyuɛnsi ablashɔn de yuz redio wev fɔ ɔt ɛn pwɛl kansa sɛl dɛn ɛn abnɔmal sɛl dɛn.
• Cryoablation: I de yuz likwid naytrɔjen ɔ likwid kabɔn dayɔgzayd fɔ friz ɛn pwɛl kansa sɛl dɛn ɛn abnɔmal sɛl dɛn.

• Embolizayshɔn tɛrapi: .

insay dis, di at we de gi bכdi to di adrenal gland de blok. Dis kin mek di blɔd nɔ go na di gland, ɛn i kin kil di kansa sɛl dɛn we de gro de.

• Tɛrapi we dɛn de tɔk to:

Dis kin yuz drɔgs ɔ ɔda tin dɛn we kin atak di kansa sɛl dɛn nɔmɔ we nɔ kin ambɔg di sɛl dɛn we gɛt wɛlbɔdi. dis tritmεnt dεn de yuz fכ mεtastas εn rεkכrεnt fכkromosaytכma.

wan tayrosin kinaz inhibito we dεn kכl sunitinib dεn de stכdi fכ mεtastas fכkromosaytכma. Dɛn drɔgs ya de mek di tumbu de gro.

Yu tink se dɛn go ebul fɔ avɔyd dis sik?

כnכfכs, no we nכ de fכ mek yu nכ gεt fiochromocytoma. Bɔt if yu de pan denja fɔ gɛt dis sik bikɔs ɔf di sik we dɛn kin gɛt frɔm yu mama ɛn papa ɛn di jin dɛm, di kɔyl fɔ yu jɛnɛtiks kin ɛp fɔ mek yu gɛt dis sik kwik kwik wan.

If ɛni wan pan yu klos famili mɛmba dɛn (brɔda ɛn sista, mama ɛn papa) dɔn gɛt fiochromocytoma, ɔ if yu gɛt jenɛtik kɔndishɔn lɛk di wan dɛn we wi bin dɔn tɔk bɔt (Multiple endocrine neoplasia 2 syndrome, Von Hippel-Lindau (VHL) disease, Neurofibromatosis type 1 (NF1), Hereditary paraganglioma syndrome, Carney-Stratakis dyad, Carney triad), i rili impɔtant fɔ tɔk to yu dɔktɔ bɔt am.

Wetin na di chans fɔ wɛl afta dɛn dɔn trit am? (Prɔgnosis) .

di autluk fכ fiokromosaytכma jεnarali rili gud if dεn trit am.wi dכn se lεk 90% pan di tכmכro dεm kin kכmכt fayn fayn wan wit כpεrayshכn.

Bɔt if dɛn nɔ trit dis sik, i kin mek i gɛt siriɔs prɔblɛm dɛn we kin mek i day . Fɔ ɛgzampul:

• Di sik we dɛn kɔl Cardiomyopathy
• Mayokarditis we gɛt di sik
• Blɔd we nɔ de kɔntrol na di bren (Cerebral hemorrhaging) .
• Fluid akyumyuleshכn na di lכng dεm (Pulmonary edema) .

Sɔm pipul dɛn we gɛt fiochromocytoma kin gɛt strok ɔ mayokardial infarkshɔn bak.

Ustɛm a fɔ go to dɔktɔ?

• If dɛn no se yu gɛt fiochromocytoma ɛn yu gɛt ɛni prɔblɛm we de mɔna yu, go to yu dɔktɔ wantɛm wantɛm.
• If yu gɛt sɔm sayn dɛm fɔ fiochromocytoma, lɛk ay blɔd prɛshɔn ɛn ed we de at, tɔk to yu dɔktɔ. Pan ɔl we fiochromocytoma nɔ kin bɔku, i impɔtant fɔ trit ay blɔd prɛshɔn.
• If yu no se wan pan yu fambul dɛm we de nia yu (brɔda ɛn sista dɛm, mama ɛn papa) gɛt jɛnɛtik kɔndishɔn lɛk `Multiple endocrine neoplasia 2 syndrome` ɔ `Von Hippel-Lindau (VHL) disease`, yu kin gɛt ay risk bak fɔ gɛt fiochromocytoma, so go to dɔktɔ fɔ tɔk bɔt jenɛtik tɛst.

Us kwɛstyɔn dɛn a fɔ aks di dɔktɔ?

If dɛn no se yu gɛt fiochromocytoma, i go fayn fɔ aks yu dɔktɔ dɛn kwɛstyɔn ya:

• Wetin mek a bin gɛt fiochromocytoma?
• Mi pikin ɛn/ɔ mi fambul dɛn kin gɛt fiochromocytoma?
• Us tritmɛnt opshɔn dɛn a gɛt?
• Wetin na di sayd ɛfɛkt dɛm we difrɛn tritmɛnt dɛn kin gɛt?
• Aw a go ebul fɔ kɔntrol mi sik dɛn?

Fɔ dɔn, di tin dɛn we impɔtant pas ɔl fɔ mɛmba (Take-Home Message) .

Okay, so, pan ɔl we fiochromocytoma na tumor we nɔ kin bɔku, bɔku tɛm i nɔ kin fayn ɛn dɛn kin trit am . Dɔn bak, i kin rɔn na famili, so if dɛn no se yu ɔ sɔmbɔdi na yu famili gɛt dis sik, i impɔtant fɔ mek dɛn du tɛst fɔ yu jɛnɛtiks. Dis kin ɛp bak fɔ no if yu de pan denja fɔ gɛt ɔda wɛl bɔdi prɔblɛm.

Mɛmba se, if yu gɛt ɛni kwɛstyɔn bɔt yu risk fɔ gɛt fiochromocytoma ɔ bɔt dis sik, nɔ fred fɔ tɔk to yu dɔktɔ. Dɛn de ya fɔ ɛp yu. Stay wit wɛlbɔdi!

Pheochromocytoma , adrenal gland, katekolamin, ay blɔd prɛshɔn, ed we de at, swet, tumor, ɛndokrin sistɛm