Pregnancy and functional paraganglioma.
The association of pregnancy with a catecholamine-secreting tumor is rare. The high maternal and fetal mortality rate is significantly reduced when the diagnosis is made antepartum and adequate management is started. In 1979 Burgess reviewed 42 cases with antepartum diagnosis, demonstrating the benefits of alpha-blockade (Obstet Gynecol 1979; 53:266-270). When diagnosis was made in the third trimester of pregnancy, a combined procedure of cesarean section and tumor resection was best. The best surgical approach in first- and second-trimester diagnosis, however, remains controversial. A case with second-trimester diagnosis is described. Following a period of alpha- and beta-blockade, a combined surgical procedure in the third trimester resulted in a healthy mother and infant. Follow-up procedures included a meta-iodobenzylguanidine scan of the mother. Postpartum, ultrasonography of the child's brain revealed periventricular leucomalacia. The prognosis associated with this finding is poor. Some more recent information about certain aspects of these tumors is also discussed.
Verstraeten
P R
PR
Department of Obstetrics and Gynecology, Groot Ziekengasthuis, 's Hertogenbosch, The Netherlands.
de Boer
R
R
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000209:etiology; D010235:Paraganglioma / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy