title: Pheochromocytoma during pregnancy treated by surgery. A case report and the review of the literature.
abstract: BACKGROUND
  Prenatal diagnosis of pheocromocytoma, although rare, is important as it allows a reduction in both maternal mortality and foetal loss. Pheocromocytoma operated on in the first trimester of pregnancy with survival of both patient and foetus is rare in literature. Our case was operated on with success after a correct and early diagnosis was obtained despite a chronic hypertension which existed long before pregnancy. Our case study well illustrates that a correct multidisciplinary approach involving endocrinologists, anesthesiologists, surgeons and gynecologists is fundamental for a positive outcome.
  
  
  METHODS
  The case of a white caucasian pregnant woman at 13th weeks of gestation with pheocromocytoma and severe and unstable hypertension that could not be pharmacologically controlled is described. Morphological diagnosis was safely obtained by Magnetic Resonance Imaging (MRI) without intravenous medium contrast agent. Pre-operative treatment consisted of therapy with alpha-blockers and rehydration. Adrenalectomy was performed through a laparotomy. Postoperative treatment consisted of rehydration and ephedrine continued until the fourth post-operative day. The post-operative period was uneventful and a new ultrasound (US) scan confirmed foetal vitality. The patient was discharged seven days after surgery. A live newborn was physiologically delivered after a nine-month pregnancy.
  
  
  CONCLUSIONS
  A correct diagnosis in all pregnant women with severe hypertension particularly those not screened for secondary hypertension and a multidisciplinary management are mandatory to obtain optimal results and avoid deleterious effects at delivery.
authors.affiliation: Dipartimento di Chirurgia, Università degli Studi di Genova, Genova , Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Varaldo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ansaldo
authors.forename: Michela
authors.initials: M
authors.lastname: Assalino
authors.forename: Andrea
authors.initials: A
authors.lastname: Massobrio
authors.forename: Michele
authors.initials: M
authors.lastname: Minuto
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Torre
authors.forename: Giacomo
authors.initials: G
authors.lastname: Borgonovo
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D010673:Pheochromocytoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery*; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D016896:Treatment Outcome