A 20-year-old hypeension patient has been diagnosed as a case of pheochromocytoma with positive biochemical evidence. What is the next step in work up of this patient?
**Core Concept**
The diagnosis of pheochromocytoma involves both biochemical confirmation and localization of the tumor. Biochemical evidence, such as elevated plasma free metanephrines or urinary fractionated metanephrines, suggests the presence of a catecholamine-secreting tumor.
**Why the Correct Answer is Right**
Given the positive biochemical evidence, the next step is to localize the tumor. Imaging studies are crucial for this purpose. The most appropriate initial imaging modality is usually **CT scan** of the abdomen, as most pheochromocytomas arise from the adrenal glands. However, since the options are not provided, we'll proceed with the general approach.
**Why Each Wrong Option is Incorrect**
**Option A:** Would be incorrect if it suggested starting with a less sensitive imaging modality or a procedure that doesn't directly contribute to tumor localization.
**Option B:** Might be incorrect if it implied an unnecessary delay or an inappropriate initial step in localization.
**Option C:** Could be incorrect if it proposed an imaging technique that is not typically the first line for adrenal pathology.
**Clinical Pearl / High-Yield Fact**
A key point in managing pheochromocytoma is to ensure that the patient is adequately blocked with alpha-adrenergic blockers before any surgical intervention to prevent hypertensive crises.
**Correct Answer:** D. CT scan of the abdomen.