title: Management of adrenal tumors in pregnancy.
abstract: Adrenal diseases, including Cushing syndrome (CS), primary aldosteronism (PA), pheochromocytoma, and adrenocortical carcinoma, are uncommon in pregnancy; a high degree of clinical suspicion must exist. Physiologic changes to the hypothalamus-pituitary-adrenal axis in a normal pregnancy result in increased cortisol, renin, and aldosterone levels, making the diagnosis of CS and PA in pregnancy challenging. However, catecholamines are not altered in pregnancy and allow a laboratory diagnosis of pheochromocytoma that is similar to that of the nonpregnant state. Although adrenal tumors in pregnancy result in significant maternal and fetal morbidity, and sometimes mortality, early diagnosis and appropriate treatment often improve outcomes.
authors.affiliation: Endocrinology Division, Department of Medicine, Stony Brook University School of Medicine, HSC T15-060, Stony Brook, NY 11794, USA. Electronic address: Deirdre.cocks.eschler@gmail.com.
authors.forename: Deirdre Cocks
authors.initials: DC
authors.lastname: Eschler
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, 1 Gustave L Levy Place, New York, NY 10029, USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Kogekar
authors.affiliation: Endocrinology Division, Department of Medicine, Mount Sinai School of Medicine, 1 Gustave L Levy Place, New York, NY 10029, USA; Department of Endocrinology, ProHealth Care Associates, Ohio Drive, Lake Success, NY 11042, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Pessah-Pollack
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000628:therapy; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000628:therapy; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000175:diagnosis* / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000175:diagnosis* / Q000628:therapy; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000628:therapy
chemical_list: D000959:Antihypertensive Agents
keywords: Adrenal cell carcinoma; Adrenal tumor; Cushing syndrome; Hyperaldosteronism; Pheochromocytoma; Pregnancy