Pheochromocytoma during pregnancy treated by surgery. A case report and the review of the literature

Emanuela Varaldo, Gianluca Ansaldo, Michela Assalino, Andrea Massobrio, Michele Minuto, Giancarlo Torre, Giacomo Borgonovo

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION:Prenatal diagnosis of pheocromocytoma, although rare, is important as it allows a reduction in both maternal mortality and foetal loss. Pheocromocytoma operated on in the first trimester of pregnancy with survival of both patient and foetus is rare in literature. Our case was operated on with success after a correct and early diagnosis was obtained despite a chronic hypertension which existed long before pregnancy. Our case study well illustrates that a correct multidisciplinary approach involving endocrinologists, anesthesiologists, surgeons and gynecologists is fundamental for a positive outcome. CASE REPORT: The case of a white caucasian pregnant woman at 13th weeks of gestation with pheocromocytoma and severe and unstable hypertension that could not be pharmacologically controlled is described. Morphological diagnosis was safely obtained by Magnetic Resonance Imaging (MRI) without intravenous medium contrast agent. Pre-operative treatment consisted of therapy with alpha-blockers and rehydration. Adrenalectomy was performed through a laparotomy. Postoperative treatment consisted of rehydration and ephedrine continued until the fourth post-operative day. The post-operative period was uneventful and a new ultrasound (US) scan confirmed foetal vitality. The patient was discharged seven days after surgery. A live newborn was physiologically delivered after a nine-month pregnancy. CONCLUSION: A correct diagnosis in all pregnant women with severe hypertension particularly those not screened for secondary hypertension and a multidisciplinary management are mandatory to obtain optimal results and avoid deleterious effects at delivery.

Original languageEnglish
Pages (from-to)227-230
Number of pages4
JournalAnnali Italiani di Chirurgia
Volume81
Issue number3
Publication statusPublished - May 2010

Keywords

  • Adrenalectomy
  • Hypertension
  • Pheocromocytoma
  • Pregnancy

ASJC Scopus subject areas

  • Surgery

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