Pheochromocytoma in Pregnancy: A Case Report

Presentation Number: SUN-0792
Date of Presentation: June 22nd, 2014

Irfan Nuhoglu*, Mustafa Kocak, Hulya Coskun, H Onder Ersoz, Cihangir Erem and Nadim Civan
KTU Medical Faculty, Trabzon

Abstract

PHEOCHROMOCYTOMA IN PREGNANCY: A CASE REPORT

INTRODUCTION:  Pheochromocytoma in pregnancy is a rare condition; with an estimated prevalance of 1/50000 pregnancy. If not properly diagnosed and treated it presents high potential of mortality and morbidity for both mother and fetus.

CASE: A 31 years old women was admitted to our endocrinology due to uncontrolled hypertension despite initiation of alpha methyl dopa therapy at 12th-week of the pregnancy. Her anamnesis revealed headache, palpitation and hypertensive attacks also before pregnancy, and laboratory examination of 24-h urine analysis resulted normetanephrine: 2565μg/day (88-444) and norepinephrine: 1009μg/day (15-80). Upper abdominal MRI scan revealed a 43*42*33mm solid mass in left surrenale and pheochromosytoma was considered. Blood pressure regulation was achieved by preoperative treatment with phenoxybenzamine, doxazosin and propranolol and the patient was underwent surrenalectomy by left lateral approach at 20th-week of pregnancy. Postoperatively the drug therapy was stopped and follow up and holter monitoring revealed regulated blood pressure values. 

CONCLUSION: The only way of diagnosing pheochromocytoma in pregnancy is its suspection. It is often confused with preeclampsia, especially in the second trimester. In early diagnosed  pheochromocytoma cases operation can be performed in the 2nd trimester following proper preparation to surgery. In cases being diagnosed in the last trimester of pregnancy, following regulation of blood pressure by alpha adrenergic blockers until fetal maturation, delivery can be achieved by cesarean section and the surrenal mass removed during the same operation.

 

Nothing to Disclose: IN, MK, HC, HOE, CE, NC