Conservative management of extra-adrenal pheochromocytoma during pregnancy.
BACKGROUND
Extra-adrenal pheochromocytomas are catecholamine-secreting tumors that arise from chromaffin cells of the paraganglion sympathetic system. All of the previously reported cases have described surgical resection during the antepartum period.


METHODS
At 14 weeks of gestation, a multiparous patient was diagnosed with an extra-adrenal dopaminergic pheochromocytoma. A decision was made to delay surgical intervention until the postpartum period. Phenoxybenzamine, 10 mg per day, was subsequently started. At 35 + 2 weeks of gestation, the patient delivered a 2,600 g infant via an uncomplicated cesarean. Three weeks later, the extra-adrenal pheochromocytoma was removed, and she also underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and rectosigmoid resection with end-to-end colostomy.


CONCLUSIONS
Conservative management of dopaminergic-secreting extra-adrenal pheochromocytomas can result in favorable maternal and fetal outcomes.
Miller
Caela
C
Department of Obstetrics and Gynecology, Division of Maternal/Fetal Medicine, National Naval Medical Center, Bethesda, Maryland 20889, USA.
Bernet
Victor
V
Elkas
John C
JC
Dainty
Louis
L
Gherman
Robert B
RB
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D000315:Adrenalectomy / Q000379:methods; D000328:Adult; D001707:Biopsy, Needle; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D010643:Phenoxybenzamine / Q000627:therapeutic use*; D010673:Pheochromocytoma / Q000175:diagnosis / Q000188:drug therapy*; D049590:Postpartum Period; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
D010643:Phenoxybenzamine