title: Bilateral pheochromocytoma during the postpartum period.
abstract: BACKGROUND
  Pheochromocytoma manifesting during pregnancy is uncommon but it is responsible for a high maternal and fetal mortality rate, especially when unrecognized. Most cases of pheochromocytoma are sporadic but they can be part of hereditary autosomal dominant syndromes.
  
  
  METHODS
  We describe a case of bilateral pheochromocytoma in a term-pregnant patient with a previous history of medullary thyroid carcinoma (MTC). Her genetic study revealed a heterozygous mutation, c.1900T>C, in the RET proto-oncogene which confirmed the diagnosis of multiple endocrine neoplasia type 2A (MEN2A). Unrecognized, the tumors caused a crisis with fatal outcome in the mother during the postpartum period. This event might have been prevented if the tumor had been detected previously.
  
  
  CONCLUSIONS
  MEN2A affected pregnancy is an unusual condition. This syndrome should be suspected when a pregnant patient has a history of MTC. Early detection and appropriate management can prevent serious maternal and fetal complications. We also reviewed the literature of MEN2A-affected pregnancies.
authors.affiliation: Department of Internal Medicine, Chulalongkorn University, Patumwan, Bangkok, Thailand.
authors.forename: Lalita
authors.initials: L
authors.lastname: Wattanachanya
authors.forename: Udomsak
authors.initials: U
authors.lastname: Bunworasate
authors.forename: Wanee
authors.initials: W
authors.lastname: Plengpanich
authors.forename: Natnicha
authors.initials: N
authors.lastname: Houngngam
authors.forename: Patinut
authors.initials: P
authors.lastname: Buranasupkajorn
authors.forename: Sarat
authors.initials: S
authors.lastname: Sunthornyothin
authors.forename: Vorasuk
authors.initials: V
authors.lastname: Shotelersuk
authors.forename: Thiti
authors.initials: T
authors.lastname: Snabboon