Phaeochromocytoma Pre-test Probability

Classic Symptom Triad

Probability Assessment

Low Probability

Absence of all three triad symptoms (Headache, Palpitations, Diaphoresis) has a very high negative predictive value (~99%) for Phaeochromocytoma.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

When to Screen

Presence of paroxysmal Hypertension, Headache, Palpitations, or Diaphoresis.

Incidentally discovered adrenal mass with > 10 Hounsfield Units (HU) on CT.

Unexplained spells of anxiety or panic accompanied by tachycardia.

Resistant hypertension or hypertension starting at a young age (< 20 years).

Family history of MEN2, VHL, or NF1.

How it Works

First-line Biochemical Tests

Test	Sensitivity	Specificity
Plasma Free Metanephrines	96-99%	80-90%
24hr Urine Metanephrines	87-90%	95-99%

The Rule of 10s (Traditional)

10% Malignant (though now considered a continuous spectrum).

10% Bilateral.

10% Extradrenal (Paragangliomas).

10% Pediatric.

10% Familial (Now recognized as 30-40% genetic).

Last Comprehensive Review: 2026

Recent Journal Updates

Cancer MedicineJul 22, 2026

Analysis of Age, Period and Cohort Trends in Cervical In Situ and Invasive Carcinomas for Assessing the Utility of Screening Approaches—Results From the Saarland Cancer Registry

Clinical Context

We think this has broad domain relevance to Phaeochromocytoma Probability.

JAMAJul 21, 2026

FDA Approves First New Active Sunscreen Ingredient in Decades

Clinical Context

We think this has broad domain relevance to Phaeochromocytoma Probability.

WHO NewsJul 15, 2026

New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

Clinical Context

We think this has broad domain relevance to Phaeochromocytoma Probability.

Phaeochromocytoma Pre-test Probability

Low Probability

When to Use

When to Screen

How it Works

First-line Biochemical Tests

The Rule of 10s (Traditional)

Clinical Pearls

Alpha Blockade Priority

The "Five Ps"

The Evidence

Primary Source

Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.

Recent Journal Updates

Phaeochromocytoma Pre-test Probability

Low Probability

When to Use

When to Screen

How it Works

First-line Biochemical Tests

The Rule of 10s (Traditional)

Clinical Pearls

Alpha Blockade Priority

The "Five Ps"

The Evidence

Primary Source

Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.

Recent Journal Updates