A 30-year-old male presents with episodic headaches, sweating, and rapid heart rate. These episodes last about 15 minutes and are followed by fatigue. He also has a family history of similar symptoms. What could be the cause, and what are the next steps?
This patient's symptoms suggest pheochromocytoma, a rare tumor of the adrenal medulla that overproduces catecholamines. The next steps would be to measure plasma free metanephrines or 24-hour urinary fractionated metanephrines, which are the tests of choice for pheochromocytoma. If these tests are positive, imaging studies such as a CT or MRI of the adrenals would be performed. Treatment typically involves surgical removal of the tumor after preoperative alpha-blockade to prevent a hypertensive crisis.