Phaeochromocytoma and Pregnancy — An Updated Appraisal

Abstract

Phaeochromocytoma in pregnancy carries a considerable risk to the mother and is even more dangerous to the fetus. It should, therefore, be kept 1. Professor. 2. Lecturer.

Phaeochromocytoma in black South Africans – a 30-year audit

“…Left ventricular hypertrophy associated with phaeochromocytoma may rarely be asymmetrical and mimic the features of HOCM, as was the case in 2 of our patients, showing reversibility several years after tumour removal. 17 When the diagnosis of phaeochromocytoma is made antepartum and when appropriate treatment is instituted, maternal mortality has fallen to as low as 2%, and fetal mortality to 11%. 18 The main differential diagnosis in pregnancy is pre-eclampsia, which is far more common.…”

Pheochromocytoma in Pregnancy: A Review of the Japanese Literature.

“…However, pheochromocytoma was diagnosed antenatally in only 11 (32%) of the 34 patients in the present Japanese review (Table 1) compared with 25% before 1969 and 52% in the period 1969-1979 [9] and 53% in the period 1980-1987 [2] in the world literature.…”

“…In the past, vaginal delivery was carried out and resulted in a higher maternal mortality (31 %) than caesarean section (19%) [9]. Of the 11 women in the present review, where a pheochromocytoma was diagnosed but not removed antenatally, delivery was by caesarean section in 5, with concurrent resection of the tumor in 2, removal at a later date in 3; there were two neonatal deaths and no maternal death.…”

“…When the diagnosis is made before 23 weeks gestation, the tumor should be removed once adrenergic blockade has been achieved. Although up until 1979 only one fetus survived out of the 5 pregnancies in which surgical intervention was undertaken before 24 weeks gestation [9], there has been a successful fetal outcome in 7 of the 8 more recently reported cases [2]. After 24 weeks gestation uterine size makes abdominal exploration and access to the tumor difficult unless the woman is first delivered.…”

“…However, mortality in both mother and fetus could be lowered when the diagnosis was made antepartum [2,7,8]. For example, maternal mortality before 1969 was 48%, and it fell to 26% in the period 1969-1979 [9] and continued to fail to 17% in 1980-1989 [2]. In this paper, we review the 35 cases with pheochromocytoma in pregnancy in the Japanese literature, including our 3 cases [10,11], and demonstrate diagnostic criteria including diagnostic imaging procedures that enable an early, correct diagnosis to be made.…”