Outcomes of concurrent Caesarean delivery and pheochromocytoma resection in late pregnancy

Abstract

Undiagnosed pheochromocytoma in pregnancy is associated with significant maternal and foetal mortality. Herein we reviewed five cases of pheochromocytoma in pregnancy occurring during late pregnancy. The mean age at presentation was 30.6 years, and the gestational age ranged from 26 to 36 weeks. All patients had elevated levels of urinary catecholamines. In three patients, the lesion was located in the adrenal gland, in one patient the urinary bladder, and there was one case of recurrent malignant pheochromocytoma with metastases. Tumour resections were performed at the time of Caesarean section in four patients, two through laparoscopy. When pheochromocytoma is diagnosed in pregnancy after the second trimester, concurrent tumour resection with Caesarean section is feasible and in our series was achieved in four cases without adverse maternal or foetal consequences.

Maternal and fetal outcomes in phaeochromocytoma and pregnancy: a multicentre retrospective cohort study and systematic review of literature

“…Elective pregnancy termination was performed in 8 (3%) patients at a median of 9 weeks (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22], all in women with recognized PPGL before or during pregnancy. Miscarriage/ intrauterine fetal loss occurred in 11 (4%) patients at a median of 18 weeks of gestation (range, 8-37), in 6 women with unrecognized PPGL during pregnancy and in 5 women who were discovered with PPGL within a median of 2 (0-10) weeks before pregnancy loss.…”

5P Strategies for Management of Multiple Endocrine Neoplasia Type 2: A Paradigm of Precision Medicine

“…Meanwhile, MEN2B-related PHEO is not more progressive than MEN2A-related PHEO ( 4 , 92 ). Of note, fertile MEN2 women are at high risk of complicated pregnancy because unrecognized PHEO that may lead to severe, and even fatal adverse maternal or fetal outcomes ( 93 , 94 ). PHEO in female MEN2 patients should be treated 3 months prior to a planned pregnancy, and for patients who are already pregnant, PHEO should be treated before the gestational age of 28 weeks ( 2 ).…”

Surgical management of pheochromocytoma in a 13-week pregnant woman

“…Pregnancy does not alter urinary catecholamines hence diagnosis is confirmed by 24 h urine VMA, metanephrines or catecholamines. Metanephrines and catecholamines can be measured in the blood as well 7 8. In adults, approximately 80% of PCC are unilateral and solitary.…”

“…α-Adrenoceptor blockade that is either phenoxybenzamine or prazosin and β-blockade is used to control tachycardia and dysrhythmia 8 11 12 14. The aim of this pretreatment is twofold: first, before undergoing surgery, blood pressure, heart rate and volume depletion should be restored as far as possible.…”