Diagnosis and management of pheochromocytoma during pregnancy: a case report.
Pheochromocytoma is known to increase morbidity and mortality. We describe a case of pheochromocytoma during pregnancy. A patient was transferred to our hospital during gestational week 15 with severe hypertension, acute pulmonary edema, and cardiomyopathy. One day after transfer, she had a spontaneous abortion of the fetus. One week after hospital transfer, she developed acute dyspnea, supraventricular tachycardia degenerating into ventricular tachycardia, and respiratory failure requiring mechanical ventilation. Pheochromocytoma caused by a right adrenal mass was diagnosed. The patient was treated with titrated doses of phenoxybenzamine, intravenous nicardipine, and metyrosine over a period of 3 weeks with resultant stabilization of her blood pressure. She underwent a successful right adrenalectomy 1 month after her initial presentation. Four months after surgery, all antihypertensive medications were discontinued and her blood pressure remained stable 1 year after the surgery. This case describes the maternal morbidity and fetal mortality that may be associated with pheochromocytoma during pregnancy.
Hermayer
K L
KL
Department of Medicine, Medical University of South Carolina, Charleston 29425, USA.
Szpiech
M
M
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D000315:Adrenalectomy; D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000328:Adult; D002395:Catecholamines / Q000652:urine; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000628:therapy; D019805:alpha-Methyltyrosine / Q000627:therapeutic use
D018674:Adrenergic Antagonists; D002395:Catecholamines; D004791:Enzyme Inhibitors; D019805:alpha-Methyltyrosine