The diagnosis of phaeochromocytoma requires both a biochemical demonstration of inappropriately increased catecholamine production as well as anatomical localisation of the tumour. The addition of plasma metanephrine and serum chromogranin A has increased the repertoire of biochemical tests available. Recent advances in functional imaging like MIBG and somatostatin receptor scintigraphy have improved the diagnostic yield in extra-adrenal, metastatic and recurrent tumours which may not be easily recognised on conventional imaging. Although excision of the tumour remains the mainstay of treatment, the importance of good peri-operative control of blood pressure and post-operative follow up care cannot be over-emphasised. This paper reviews the various tests currently available and their roles in the evaluation of phaeochromocytoma. It also highlights some of the peri-operative issues in the management of this condition.
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