[Malignant pheochromocytoma in the 17th week of gestation].
BACKGROUND
Pheochromocytoma during pregnancy is rare and represents a high risk for mother and fetus. Due to the variable clinical presentation it may be mistaken for preeclampsia.


METHODS
A 34-year-old primipara with hypertension up to 240/120 mmHg. After diagnosis of a pheochromocytoma its resection together with lymph node metastasis in the 17th week of gestation was performed.


CONCLUSIONS
The definitive diagnosis is confirmed by elevation of serum catecholamines and their metabolites in a 24-h urine collection. Localization during pregnancy can be made by ultrasound and MRI. The definitive treatment is surgical removal after administration of adrenergic blockers. If discovered later in pregnancy, delivery by elective caesarean section followed by tumor resection is recommended. Since about 10 % of pheochromocytomas are malignant, postpartum screening is required to detect and treat extraadrenal or metastatic tumors by MIBG scintigraphy, chemotherapy or surgical procedures.
Remmel
E
E
Chirurgische Klinik, Departement Chirurgie, Universität Basel.
Oertli
D
D
Holzgreve
W
W
Hösli
I
I
Staub
J J
JJ
Harder
F
F
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D010673:Pheochromocytoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D011262:Pregnancy Trimester, Second