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


COD: 03_2010_227-230 Categorie: ,

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

Ann. Ital. Chir., 2010; 81: 227-230

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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.