Diagnostic Code 7918 · 38 CFR §4.119
A pheochromocytoma is a tumor of the adrenal gland that produces excessive adrenaline and noradrenaline, causing episodes of severe high blood pressure, rapid heartbeat, sweating, headaches, and panic-like attacks. These episodes can be life-threatening due to extreme blood pressure spikes that can cause stroke or heart attack. About 90% are benign, but approximately 10% are malignant and may spread. The condition requires treatment, usually surgical removal of the tumor. Veterans may develop it from genetic factors or as part of multiple endocrine neoplasia (MEN) syndromes.
| Rating | Criteria |
|---|---|
| See pathways% | DC 7918 has no native percentage scale. The VA evaluates pheochromocytoma as either a malignant or benign neoplasm. Malignant tumors are rated under DC 7914 (malignant neoplasm of endocrine system) — 100% mandatory during active treatment, six-month carryover, then residuals. Benign tumors are rated under DC 7915, with residuals evaluated by their effects (hypertension under DC 7101, post-surgical adrenal insufficiency under DC 7911). |
Lab tests showing elevated catecholamines (plasma metanephrines, 24-hour urine catecholamines) confirm the diagnosis. CT or MRI showing the adrenal tumor documents it. Blood pressure records showing hypertensive episodes demonstrate the severity. Pathology from surgical removal determines whether the tumor is benign or malignant (which affects the rating approach). Post-surgical adrenal function tests show whether replacement hormones are needed.
About 90% of pheochromocytomas are benign. The remaining 10% can be malignant. All require treatment because of the dangerous hormone excess. If malignant, it receives the 100% cancer rating under DC 7914 during treatment. If benign, it is rated under DC 7915 based on residuals of endocrine dysfunction.
Most veterans experience significant improvement after surgery. However, many need ongoing monitoring for recurrence, and some develop adrenal insufficiency (rated under DC 7911) requiring lifetime hormone replacement. Any cardiovascular damage from the period of uncontrolled hypertension is permanent and separately ratable.
Yes. Pheochromocytoma is a common component of multiple endocrine neoplasia Type 2 (MEN2). If you have pheochromocytoma along with other endocrine tumors, you may have a polyglandular syndrome (DC 7912) where each affected gland is rated separately.