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1. Classically, pheochromocytoma manifests as spells with the following 4 characteristics:
2. Typical patterns of the spells are as follows:
3. The following may also occur during spells:
4. Clinical signs associated with pheochromocytomas include the following:

Anxiety, sense of doom

Weakness

Nausea

Headaches

Diaphoresis

Fever

Hypertension: Paroxysmal in 50% of cases

Weight loss

Severe hypertension

Tachyarrhythmias

Epigastric pain

Pallor

Tremor

Palpitations

Constipation

Flank pain

Hypertensive retinopathy

Over time, spells tend to occur more frequently and become more severe as the tumor grows

Frequency may vary from monthly to several times per day

Duration may vary from seconds to hours

Postural hypotension: From volume contraction

Neurofibromas

Pulmonary edema