title: Vaginal delivery in a patient with pheochromocytoma, medullary thyroid cancer, and primary hyperparathyroidism (multiple endocrine neoplasia type 2A, Sipple's syndrome).
abstract: Multiple endocrine neoplasia 2A (MEN 2A), or Sipple's syndrome is a rare inherited dominant syndrome, characterised by medullary thyroid carcinoma, adrenal pheochromocytoma and hyperparathyroidism, due to specific RET proto-oncogene mutations. The women with MEN 2A syndrome are at risk of complicated pregnancy because of unrecognised pheochromocytoma and transmission of RET mutation to the progeny. We report a case of a woman with MEN 2A diagnosed in early pregnancy. Alpha-blockade medical therapy was used effectively and time was given for fetal maturation. Uncomplicated vaginal delivery performed under epidural analgesia. Six weeks postpartum adrenalectomy, thyroidectomy and parathyroidectomy were performed uneventfully.
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Muhammad Anas
authors.initials: MA
authors.lastname: Muzannara
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Nasser
authors.initials: N
authors.lastname: Tawfeeq
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Nasir
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Mohammed Khulaif
authors.initials: MK
authors.lastname: Al Harbi
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Georges
authors.initials: G
authors.lastname: Geldhof
authors.affiliation: Department of Anesthesia, King Abdulaziz Medical City, Riyadh, KSA.
authors.forename: Vassilios
authors.initials: V
authors.lastname: Dimitriou
keywords: Medullary thyroid cancer; multiple endocrine neoplasia 2A; pheocromocytoma; pregnancy