- History
- Pheochromocytoma
- Episodic headaches, palpitations, sweating, anxiety, tremor
- Paroxysmal or sustained hypertension
- Abdominal or flank pain
- Family history of MEN2, VHL, NF1
- Conn’s syndrome (Aldosterone-producing adenoma)
- Hypertension (often refractory)
- Muscle weakness, cramps, fatigue (due to hypokalemia)
- Polyuria, nocturia
- Cushing’s syndrome (Cortisol-producing tumor)
- Weight gain (central obesity)
- Facial rounding, “moon face,” buffalo hump
- Proximal muscle weakness
- Easy bruising, purple abdominal striae
- Hypertension, glucose intolerance
- Mood changes
- Adrenocortical carcinoma
- Abdominal pain/fullness from mass effect
- Symptoms of hormone excess (Cushingoid, virilization/feminization)
- Metastases
- History of known primary malignancy
- Weight loss, malaise
- Examination
- Pheochromocytoma
- Hypertension (paroxysmal or sustained)
- Tachycardia or arrhythmias
- Orthostatic hypotension possible
- Conn’s syndrome
- Hypertension (often moderate-severe)
- Muscle weakness/tetany from hypokalemia
- No signs of volume overload
- Cushing’s syndrome
- Central obesity, moon face, buffalo hum
- Skin thinning, easy bruising, purple striae
- Proximal muscle wasting
- Hypertension
- Hirsutism if androgen excess
- Adrenocortical carcinoma
- Palpable abdominal mass if large
- Signs of hormone excess (Cushingoid, virilization/feminization)
- Metastases
- Signs of primary cancer or systemic illness
- Cachexia, lymphadenopathy