Tunlai hian Pheochromocytoma an tih tumor hmuh tur awm lo tak chungchang hi kan sawi dawn em ni?

A chang chuan rang takin thisen sang i nei thin em? Nge i thawkrim mai mai em ni? Thinlung na tak nen lu na i nei em? Heng zinga tlemte hi natna khirh tak a ni tih ngaihtuah vat vat suh. Mahse, heng symptoms te hi a la awm reng a nih chuan, a bik takin thisen sang control harsa tak nen chuan tlem tal ngaihtuah a tha. Vawiin hian kan sawi dawn a, natna pakhat, a tlem deuh a, mahse a dik taka hmuhchhuah a nih chuan, a enkawl tha hle. Chu chu pheochromocytoma an ti a.

Pheochromocytoma hi eng nge ni? A awlsam zawngin i hrethiam ang u.

A awlsam zawngin pheochromocytoma chu adrenal glands lai tak, adrenal medulla-a lo awm tumor a ni. Heng tumor te hi cell chi khat, chromaffin cells an tih atanga siam a ni. Heng cell te hian kan taksa "fight or flight" response atana mamawh hormone thisenah an siam chhuak a, an chhuah tir thin. Ngaihtuah teh, rang taka hlauthawng emaw, stress nasa tak i hmachhawn emaw hian i taksaa thil thleng danglam - i heart rate a sang a, i thawk a, i taksa a nghing - heng hormone te hian hei hi an mawhphurtu an ni.

Pheochromocytoma hi adrenal gland pakhatah chauh a lo awm tlangpui. Mahse, a chang chuan gland pahnihah a lo awm thei. Gland pakhatah hian tumor pakhat aia tam a awm theih a ni.

Pawimawh tak chu pheochromocytoma tam zawk hi chu benign (malignant ni lo) an ni . Chumi awmzia chu taksa peng dangah an darh lo tihna a ni. Mahse, 10% leh 15% inkar hi cancer a ni thei. Hei hi cancer natna a nih chuan a darh dan azirin chi hrang hrangah tarlan a ni:

• Localized pheochromocytoma: Tumor hi adrenal gland pakhat emaw pahnih emaw chauh ah a awm a.
• Regional pheochromocytoma: Cancer hi adrenal glands bula lymph node-ah emaw, tissue dang emaw-ah a darh tawh a ni.
• Metastatic pheochromocytoma: Cancer hi taksa peng hla tak tak, thin, lung emaw ruh emaw-ah a darh tawh a ni.
• Recurrent pheochromocytoma: Cancer hi enkawl hnuah a lo let leh tawh a ni. A hmaa a awmna hmunah emaw, hmun dangah emaw pawh a ni thei.

Kan taksaa heng adrenal glands te hi engte nge ni? An hnathawh chu eng nge ni?

Adrenal gland pahnih kan nei a. Kan pum hnung lamah, kan kal chung lamah, kawr ang maia awm an ni. Kan endocrine system-a tel ve an ni. Adrenal gland tin hian hmunpui pahnih an nei a. Pawn lam layer chu adrenal cortex an ti a, a lai lam chu adrenal medulla an ti bawk.

Kan adrenal medulla hian hormone pawl pakhat catecholamines an tih chu a siam chhuak a. Heng hormone te hian kan taksaa thil pawimawh tak tak engemaw zat an control a:

• Lungphun na tak
• Thisen sang a ni
• Thisen sugar level `(Thisen glucose)`
• Kan taksain stress a chhan dan (the "fight or flight" response) .

Catecholamine chi hrang hrangte chu:

• Dopamine a ni
• Epinephrine (Adrenaline) `(Epinephrine / Adrenaline)` tih a ni
• Norepinephrine (Noradrenaline) `(Norepinephrine / Noradrenaline)` hmanga siam a ni

Pheochromocytoma a awm chuan heng hormone, adrenaline leh noradrenaline te hi a tul aia tam thisenah a chhuah tir thei a ni. Chutah chuan symptom hrang hrang a lo lang tan ta a ni.

Pheochromocytoma leh Paraganglioma hi eng nge an danglamna?

Hengte hi tumor chi hnih inang tak, hmuh tur awm lo tak tak an ni. An pahnih hian kan sawi tawh ang chiah chromaffin cell atanga lo chhuak an ni. Mahse, pheochromocytoma hi adrenal gland lai takah (adrenal medulla) a lo awm a, paraganglioma erawh adrenal gland pawn hmun dangah a lo awm thung .

He natna hi tuin nge vei tam ber? Engtiang chiahin nge a hluar?

Pheochromocytoma hi kum eng pawhah a lo awm thei a, mahse kum 30 leh 50 inkar ah a awm tam ber a, 10% vel chu naupan lai atanga report a ni.

Hei hi tumor hmuh tur awm lo tak a ni . Hetiang dinhmun hi mi engzat nge nei tih chiang taka sawi a harsa hle. Mi thenkhatin symptom an neih loh avangin natna hi hriat lohvin a awm thei. Thisen sang nei zinga 1% aia tlem chuan pheochromocytoma an nei nia chhut a ni.

Pheochromocytoma vei hian eng symptom nge a lantir?

Pheochromocytoma symptoms hi tumor hian thisenah hormone adrenaline (epinephrine) emaw noradrenaline (norepinephrine) emaw a chhuah tam lutuk hian a awm thin. Mahse, tumor thenkhat chuan heng hormone te hi an siam tam lutuk lo va, asymptomatic an ni thei bawk.

A lan chhuah dan hmuh tam ber chu:

• Thisen sang (Hypertension): Hei hi a lan chhuah dan ber a ni. A chang chuan thunun a harsa thin.
• Lu na: Lu na na tak, rang tak a ni thei.
• Chhan awm lova thawk hah lutuk.
• Palpitations hi thinlung thawk chak tak, mumal lo emaw, na tak tak emaw hriatna a ni.
• I taksa a nghing ang maia inhriatna.

A lan chhuah dan tlangpui:

• Chhung leh/ emaw pum na.
• Vun chu a hma aia a rawn sen nghal zung zung.
• Nausea leh/ emaw, luak chhuak.
• Kawthalo.
• Ek khal.
• Orthostatic hypotension chu i ding chhuak a, thisen sang tlahniam nghal mai a ni. Chumi awmzia chu thut atanga i ding nghal chuan i lu a buai tihna a ni.
• Chhan awm lovin taksa rihna tihtlem.

Heng symptoms te hi thil thleng thenkhat hnuah a lo lang thei a, a na zual thei bawk. Entir nan:

• Taksa tihchakna nasa tak.
• Taksa hliam emaw rilru hahna nasa tak emaw.
• Nau neih a ni.
• Anesthesia lak chhuah.
• Surgery tih a ni.
• Tyramine tamna ei tur (e.g. red wine, chocolate, cheese) ei.

Symptoms hi a awm reng em? Nge an lo kal leh chhuak em?

Pheochromocytoma vei chuan thisen sang reng reng a nei thei a, a lo kal leh chhuak thei bawk .

Mi thenkhat chuan "paroxysmal attacks," emaw, symptoms attack nghal mai emaw an nei thei bawk. Chumi awmzia chu thisen sang a sang nghal tihna a ni a, chu chu lu na nasa tak, thinlung chakna sang, leh thawk hah lutuk ang chi symptoms te nen a inzawm tihna a ni. Heng "attack" te hi ni khatah vawi tam tak a thleng thei a, thla khatah vawi khat emaw vawi hnih emaw pawh a thleng thei bawk.

Pawimawh: Heng symptoms zinga pakhat tal i neih chuan, a bik takin thisen sang thut, lu na, thawk hah, leh thinlung natna te i neih chuan doctor thurawn lak a pawimawh hle.

Engvangin nge pheochromocytoma hi a lo awm? A chhante chu engte nge ni?

A tam zawkah chuan pheochromocytoma hi a chhan chiang tak hmuh tur a awm lo . Random takin a thleng thin.

Mahse, 25% atanga 35% ah chuan he natna hi hereditary conditions nen a inzawm tlat a ni. A bulpui ber thenkhat chu:

• Multiple endocrine neoplasia 2 syndrome, chi A leh B (MEN2A leh MEN2B) te hi a awm a.
• Von Hippel-Lindau (VHL) natna a ni
• Neurofibromatosis chi khat (NF1) a awm thin.
• Hereditary paraganglioma natna hi a ni
• Carney-Stratakis dyad [paraganglioma leh chaw kawng stromal tumor (GIST)] a ni.
• Carney triad (paraganglioma, GIST leh pulmonary chondroma) te hi a awm thei lo.

Heng genetic condition bakah hian pheochromocytoma hi gene hrang hrang 10 tal mutations avang hian a lo awm thei bawk.

He natna hi engtin nge an hriat chhuah? (Diagnosis) tih a ni.

Pheochromocytoma hi hriat a harsa thei hle a, a chhan chu tumor hmuh tur a awm lo va, a chang chuan symptom a awm lo. A châng chuan, chhan dang vanga test an tih laiin tumor hi a thleng mai maiin an hmuchhuak ṭhin.

Doctor-in he natna hi a rinhlelh theihna chhan hrang hrang a awm a:

• Nangmah ta a niMedical history chipchiar tak, a bik takin chhungkaw zingah pheochromocytoma nei tawh leh awm loh.
• Taksa leh damdawi lam enfiahna kimchang.
• Some specific symptoms , entirnan "paroxysmal attacks" kan sawi tawh leh thisen sang, enkawlna pangngaiin a thunun loh te.

Eng ang test nge tih thin?

I doctor chuan pheochromocytoma i vei leh vei loh finfiah nan a hnuaia test te hi a rawt thei ang:

• Darkar 24 chhunga zun test: Hei hi nitin i zun lakkhawm a, a chhunga catecholamines awm zat tehna a ni. Heng hormone te a chhiat huna thil siam chhuah te pawh a teh bawk. Heng level te hi a tlangpui aia sang a nih chuan pheochromocytoma chhinchhiahna a ni thei.
• Thisen catecholamine test: Hengte hian thisena catecholamine awm zat a teh thin. Zun test ang bawkin hormone tihchhiatna avanga thil lo chhuak te pawh an zawng thin.
• CT scan (Computer Tomography scan): Hei hian X-ray hrang hrang hmangin i taksa chhung lam thlalak chipchiar tak a siam a. I doctor chuan i adrenal glands en nan hetiang hian a rawt mai thei.
• MRI scan (MRI - Magnetic Resonance Imaging): Hei hian magnet, radio wave leh computer hmangin taksa chhung lam chipchiar taka thlalak a siam a. Adrenal glands enfiah nan pawh hman a ni.

Natna hi finfiah a nih veleh test dang neih leh theih a ni a, chu chu cancer (malignant) nge benign (benign) a nih leh nih loh hriat theih a ni a, taksa peng dangah pawh a darh tawh em tih hriat theih a ni bawk.

Engvangin nge Genetic Testing hi a pawimawh?

Pheochromocytoma i vei tih hmuhchhuah a nih chuan, i doctor chuan cancer dang vei theihna hlauhawma inherited syndrome i neih leh neih loh hriat nan genetic counselling leh test neih a rawt mai thei.

Hetiang ang case-ah hian genetic testing neih a tha thei ang:

• Nangmah emaw i chhungkaw zinga mi emaw hian hereditary pheochromocytoma emaw paraganglioma syndrome emaw nena inzawm symptoms i neih chuan.
• I adrenal gland pahnih ah tumor i neih chuan.
• Adrenal gland pakhatah tumor pakhat aia tam a awm chuan.
• Thisenah catecholamines level sang zawk symptoms a awm chuan.
• Kum 40 tlin hmaa pheochromocytoma hmuhchhuah a nih chuan.

Genetic test-a gene inthlak danglamna a hmuh chuan, genetic counselor chuan i chhungkaw member dangte (asymptomatic ni lo mahse hlauhawma awmte) pawh he test hi tihsak turin a rawt thei ang.

Pheochromocytoma hi eng enkawlna nge ni?

Hei hi enkawlna tha ber chu a theih chuan surgery hmanga tumor lak chhuah hi a ni .

Enkawlna thlan dan hi thil engemaw zatah a innghat a:

• Tumor lian leh te.
• Tumor chu cancer (malignant) emaw, benign (benign) emaw a nih pawhin.
• Catecholamine hormone a pun vangin symptom a awm leh awm loh.
• Tumor hi hmun khatah chauh a ni em, a nih loh leh taksa peng dangah a darh tawh em? (Metastasis a awm tawh) .
• Natna hi a vawi khatna atana hmuhchhuah a nih leh nih loh, a hmaa enkawl hnua a lo lang leh tawh em tih.

Adrenal hormone tihpun avanga symptom i neih chuan i doctor chuan chutiang symptoms control nan damdawi a pe thei che a ni. Entir nan:

• Thisen sang level pangngaia awm reng theihna tur damdawi, alpha-blockers ang chi te.
• Heart rate pangngaia awm reng theihna tur damdawi, beta-blockers ang chi te.
• Adrenal gland atanga hormone chhuak tam lutuk te nghawng tikhawlo thei damdawi.

Pheochromocytoma enkawlna kawng hrang hrangte chu:

• Inzai
• Radiation hmanga enkawlna a ni
• Chemotherapy hmanga enkawl a ni
• Ablation hmanga enkawl a ni
• Embolization hmanga enkawl a ni
• Targeted therapy hmanga enkawlna

Nang leh i medical team te chuan i tan a tha ber tur treatment plan chu in ruat dun ang.

Enkawl dan tlangpui

• Inzai:

Hei hi pheochromocytoma enkawlna ber a ni. Tumor 90% vel chu surgery hmangin hlawhtling takin lakchhuah theih a ni .

I doctor chuan i adrenal gland pakhat emaw, a pahnih emaw paih chhuah nan operation (adrenalectomy) a rawt thei ang. Surgery neih chhung hian surgeon chuan a chhehvel tissue leh lymph node te chu a enfiah ang a, tumor hi a darh tawh em tih a enfiah ang. A neih chuan chu tissue chu an la chhuak ang, a theih chuan.

Operation hnuah i thisen emaw i zun emaw chu catecholamine level a awm leh awm loh enfiah a ni ang. Level a normal leh chuan pheochromocytoma cell zawng zawng chu paih vek a ni tawh tihna a ni.

Adrenal gland pahnih hi lakchhuah a nih chuan adrenal glands atanga hormone siam chhuah thlak nan i dam chhung zawng hormone therapy i ei a ngai dawn a ni.

• Radiation hmanga enkawlna: 1.1.

Hei hi cancer cell tihhlum emaw, a lo thang chak lohna tur emaw atana hman thin a ni. Hei hi a theih ang anga tissue hrisel tichhe lo zawnga tih a ni.

Radiation therapy hi chi hnih a awm a, chungte chu:

• External radiation therapy: Radiation hi taksa pawn lama machine atanga cancer awmna hmuna thlen a ni.
• Internal radiation therapy: Radioactive substance chu needle, chi, wire emaw catheter emaw-ah dahin doctor-in cancer awmna hmunah emaw, a bulah emaw a dah lut a ni.

Radiation therapy chi hrang hrang chu cancer hi localized, regional, metastatic, recurrent a nih leh nih lohah a innghat a ni. Malignant pheochromocytoma hi external beam radiation therapy leh/ emaw 131I-MIBG therapy hmanga enkawl a ni tlangpui. 131I-MIBG hi radioactive substance a ni a, cancer cell thenkhatah a inzawm a, a that thin.

• Chemotherapy hmanga enkawlna:

Hei hian damdawi hmangin cancer cells te chu a that a, an inthen darh leh a pun chak loh nan emaw, cancer thanna tur a titawp emaw a ni. Heng damdawi te hi thisen kal tlanga pek a ni tlangpui. Hei hi enkawlna hlawhtling tak ni mah se, side effect a nei thei a ni.

• Ablation hmanga enkawlna:

Hei hi minimally invasive treatment a ni. Tumor te tihchhiat nan hian lumna nasa tak emaw, khaw lum lutuk emaw a hmang thin.

• Radiofrequency ablation: Radiofrequency ablation hian radio wave hmangin cancer cell leh cell pangngai lo te chu a lum a, a tichhia a ni.
• Cryoablation: Liquid nitrogen emaw liquid carbon dioxide hmangin cancer cell leh cell pangngai lo te chu freeze leh tihchhiat nan a hmang thin.

• Embolization hmanga enkawlna: 1.1.

Hetah hian adrenal gland-a thisen petu artery chu a block a ni. Hei hian gland-a thisen kal chu a titawp a, chuta cancer cell lo thang lian te chu an thi ta a ni.

• Targeted therapy hmanga enkawlna: 1.1.

Hei hian damdawi emaw thil dang emaw a hmang a, chu chuan cell hriselte tichhe lovin cancer cell chauh a bik takin a bei a ni. He enkawlna hi metastatic leh recurrent pheochromocytoma tan hman a ni.

Tyrosine kinase inhibitor sunitinib an tih chu metastatic pheochromocytoma tan zirchian mek a ni. Heng damdawi te hian tumor thanna a titawp thin.

He natna hi ven theih a ni em?

Vanduaithlak takin pheochromocytoma hi ven theih a ni lo . Mahse, hereditary syndrome leh genes avanga he natna vei theihna hlauhawm i nih chuan genetic counseling hian screening leh a hmaa hriatchhuahna kawngah a pui thei a ni.

I chhungte hnai tak tak (unau, nu leh pa) zingah pheochromocytoma nei tawh emaw, a hmaa kan sawi tawh ang chi genetic condition i neih chuan (Multiple endocrine neoplasia 2 syndrome, Von Hippel-Lindau (VHL) disease, Neurofibromatosis type 1 (NF1), Hereditary paraganglioma syndrome, Carney-Stratakis dyad, Carney triad), i doctor nen inbiakna neih a pawimawh hle.

Enkawlna hnua dam leh theihna chance chu engzat nge ni? (Prognosis) tih a ni.

Pheochromocytoma hi enkawl a nih chuan a tlangpuiin outlook a tha hle .Tumor 90% vel chu surgery hmanga hlawhtling taka lakchhuah theih a nih thu kan sawi tawh a.

Mahse, enkawl loh chuan he natna hian harsatna lian tak, nunna atana hlauhawm tak pawh a thlen thei a ni . Entir nan:

• Lung lam natna (Cardiomyopathy) a awm
• Myocarditis natna (Myocarditis) a ni
• Thluak chhunga thisen chhuak thunun loh (Cerebral hemorrhaging) .
• Lung chhunga tui awmkhawm (Pulmonary edema) .

Pheochromocytoma vei thenkhat pawh hi stroke emaw myocardial infarction emaw an vei thei bawk.

Engtikah nge Doctor ka hmuh ang?

• Pheochromocytoma i vei tih hmuhchhuah a nih a, harsatna thlen thei i neih chuan doctor pan nghal rawh.
• Pheochromocytoma symptoms, thisen sang leh lu na te i neih chuan doctor nen inbia ang che. Pheochromocytoma hi a tlem hle nachungin thisen sang enkawl hi a pawimawh hle.
• I chhungte hnai tak (unau, nu leh pa) zinga pakhatin `Multiple endocrine neoplasia 2 syndrome` emaw `Von Hippel-Lindau (VHL) disease` emaw ang chi genetic condition a nei tih i hriat chuan pheochromocytoma vei theihna chance sang zawk i nei thei bawk a, chuvangin doctor pan la, genetic test chungchang sawi rawh.

Doctor hnenah eng zawhna nge ka zawh ang?

Pheochromocytoma i vei tih hmuhchhuah a nih chuan i doctor hnenah heng zawhnate hi zawh a \angkai thei ang:

• Engvangin nge pheochromocytoma ka neih?
• Ka fate leh/ emaw ka chhungte hian pheochromocytoma an vei thei ang em?
• Eng enkawlna kawng nge ka neih?
• Enkawlna hrang hrang hian eng side effect nge a neih?
• Engtin nge ka symptoms te hi ka enkawl theih ang?

A tawp berah chuan hriat reng tur pawimawh ber ber (Take-Home Message) .

Okay, chuvangin, pheochromocytoma hi tumor hmuh tur awm lo mahse, benign leh enkawl theih a ni fo . Tin, chhungkaw hrang hrangah a kal thei bawk a, chuvangin nangmah emaw i chhungkaw zinga mi emaw hian he natna hi i vei tih hmuhchhuah a nih chuan genetic testing neih a pawimawh hle. Hei hian hriselna lama harsatna dang i neih leh neih loh hriat theihna kawngah pawh a pui thei bawk.

Pheochromocytoma vei theihna tur emaw, he natna chungchangah emaw zawhna i neih chuan doctor nen inbiakna neih hlau suh. I tanpui turin an lo kal a ni. Hrisel takin awm rawh!

Pheochromocytoma , adrenal gland, catecholamines, thisen sang, lu na, thawk hah, tumor, endocrine system