Successful management of a third-trimester pregnancy complicated by pheochromocytoma: case report

Abstract

Pheochromocytoma (PH) is a tumor that arises from chromaffin cells of the adrenal medulla. Though being this benign neoplasm very rare in pregnancies, lack of treatment nevertheless causes high mortality rates for both the mother and the fetus. Classic symptoms related to PH are hypertension, abdominal pain, diaphoresis, and headache; but it can be easily misdiagnosed as gestational hypertension or preeclampsia. Its appearance is sporadic, but there are some genetic disorders that favor its onset (e.g. MEN 2A and 2B). Individual management is needed, because no single protocol is suitable in such a complex and rare condition. In this paper we describe our experience in the clinical and surgical management of a young pregnant patient affected by PH, and in particular the specific and unique pharmacological treatment with doxazosin, the use of corticosteroids and a close monitoring of fetal well-being, which proved being an effective approach.

摘要

嗜铬细胞瘤（PH）是由肾上腺髓质的嗜铬细胞产生的肿瘤。虽然这种良性肿瘤在怀孕期间非常罕见, 但治疗不合适会导致母亲和胎儿的高死亡率。与PH相关的典型症状是高血压、腹痛、发汗和头痛, 但它很容易被误诊为妊娠期高血压或先兆子痫。表面上看, 该病是散发的, 但有一些遗传性疾病易发此病（例如多发性内分泌腺瘤病2A型和2B型）。该病需要进行个体管理, 因为没有一种方案适合这种复杂和罕见的情况。本文描述了我们在一位合并PH的年轻妊娠患者身上的临床和外科方面的治疗经验, 事实证明用具有特异性和唯一性药物疗效的多沙唑嗪、用皮质类固醇和密切监测胎儿健康是有效的治疗方法。

Keywords:

• Pheochromocytoma
• pregnancy
• doxazosin
• cesarean section
• laparoscopy

Disclosure statement

No potential conflict of interest was reported by the authors.