Adrenal tumours in pregnancy: diagnostic challenge and management dilemma

Phoon, Jessie Wai Leng; Kanalingam, Devendra; Chua, Hong Liang

doi:10.11622/smedj.2013068

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…The most common presenting features in the UKOSS phaeochromocytoma cases were palpitations (40%, 95% CI 12.2–73.7), headaches (20%, 95% CI 2.5–55.6) and hypertension (20%, 95% CI 2.5–55.6). The previously reported cases had similar findings; palpitations affected 29.3% (95% CI 21.4–38.1) and headache affected 34.1% (95% CI 25.8–43.2). However, although the most noticeable feature in the previously reported cases was hypertension (73.9%, 95% CI 65.3–81.5), blood pressure control varied in the UKOSS cohort of women with phaeochromocytoma in pregnancy.…”

Section: Resultssupporting

confidence: 77%

“…reviewed all articles, and individual cases common to more than one report were identified and excluded to ensure no individual case was compared twice. The majority of phaeochromocytoma cases were captured in two systematic reviews as well as in three additional case reports, providing a total of 123 additional phaeochromocytomas for comparison. For primary aldosteronism there was one systematic review as well as 15 individual cases, resulting in 34 cases for comparison.…”

Section: Methodsmentioning

confidence: 99%

“…For primary aldosteronism there was one systematic review 10 as well as 15 individual cases, [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] resulting in 34 cases for comparison. For Cushing's syndrome, there were two systematic reviews 25,26 as well as two individual cases 9,27 (156 cases in total).…”

Section: Data Collectionmentioning

confidence: 99%

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Hormone‐secreting adrenal tumours cause severe hypertension and high rates of poor pregnancy outcome; a UK Obstetric Surveillance System study with case control comparisons

Quartermaine

Lambert

Rees

et al. 2017

BJOG

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Section: Resultssupporting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Hormone‐secreting adrenal tumours cause severe hypertension and high rates of poor pregnancy outcome; a UK Obstetric Surveillance System study with case control comparisons

Quartermaine

Lambert

Rees

et al. 2017

BJOG

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“…The differential diagnosis includes primary adrenal tumors such as pheochromocytoma/paraganglioma (PPGL), adrenocortical carcinoma (ACC) or metastatic disease. Their rarity precludes formal guidelines, and the management is decided in each case individually preferably by a multidisciplinary team including an endocrinologist, maternal-fetal medicine specialist and any other discipline deemed necessary [1]. Treatment may be either medical or surgical depending on the final diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

et al. 2022

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Adrenal nonadenomatous tumors (NAT) first identified during pregnancy are very rare and pose a diagnostic and therapeutic dilemma with significant risks for the mother and fetus. The aim of this study is to report a case of a large adrenal NAT identified in pregnancy and literature review. A literature search was conducted, and data were summarized. A 37-year-old primigravida woman, with a history of melanoma, excised 12 years before presentation without recurrence, presented at 35 weeks gestation due to intractable right flank pain. MRI demonstrated an eight cm, heterogeneous, septate, right adrenal mass suspected to be either pheochromocytoma/paraganglioma (PPGL), adrenocortical carcinoma or metastasis. Blood metanephrines were sent urgently to enable a safe delivery and were within normal range, as were cortisol and androgen levels. A biopsy was taken from a palpable breast mass as well as from an ovarian mass during the operation. At 36 weeks gestation, she was delivered by cesarean section. PET computed tomography performed after delivery revealed the extensive metastatic spread of recurring melanoma including the right adrenal gland. Timely diagnosis and management by a multidisciplinary team are important to avoid a catastrophic outcome. There is no consensus on optimal management and timing of delivery. PPGL should be ruled out before delivery.

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“…The diagnosis is first suspected clinically and then confirmed based on a combination of clinical, biological and radiological arguments. They are generally manifested by a paroxysmal hypertension often resistant to medical treatment with a triad: headache, sweat, palpitation otherwise there are atypical forms which should not be ignored [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical and anesthetic management of paraganglioma diagnosed in a 2nd trimester parturient: Case report

Aftiss¹,

Mezzioui²,

Aidouni³

et al. 2021

Annals of Medicine and Surgery

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Introduction Neuroendocrine tumors represent a rare entity whose diagnosis is based on clinical, biological and radiological arguments. When they are secreting, they expose the patient to serious complications that can be much more severe during pregnancy and engage the vital prognosis of both the mother and the fetus, which requires multidisciplinary management: anesthesiologist resuscitator - obstetrician – endocrinologist. Case presentation In our article, we report the case of a patient with an estimated pregnancy at 25 weeks of amenorrhea (WA) with a history of 3 miscarriages related to atypical gravid hypertension. The treatment consisted of preoperative medical preparation followed by removal of the paraganglioma and postoperative monitoring. The maternal-fetal evolution was favorable. Conclusion The non-negligible morbi-mortality of this type of tumors require a multidisciplinary management.

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Adrenal tumours in pregnancy: diagnostic challenge and management dilemma

Cited by 8 publications

References 13 publications

Hormone‐secreting adrenal tumours cause severe hypertension and high rates of poor pregnancy outcome; a UK Obstetric Surveillance System study with case control comparisons

Hormone‐secreting adrenal tumours cause severe hypertension and high rates of poor pregnancy outcome; a UK Obstetric Surveillance System study with case control comparisons

Adrenal metastatic melanoma first identified during pregnancy: a diagnostic challenge

Surgical and anesthetic management of paraganglioma diagnosed in a 2nd trimester parturient: Case report

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