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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:

Constipation

Palpitations

Postural hypotension: From volume contraction

Weakness

Fever

Hypertensive retinopathy

Headaches

Nausea

Pallor

Severe hypertension

Weight loss

Tremor

Duration may vary from seconds to hours

Diaphoresis

Anxiety, sense of doom

Flank pain

Hypertension: Paroxysmal in 50% of cases

Frequency may vary from monthly to several times per day

Epigastric pain

Tachyarrhythmias

Neurofibromas

Pulmonary edema

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