Endocrine Abstracts

Introductıon: Pheochromocytoma is a tumor originating from the chromaffin cells. These tumors secrete catecholamines which act on target organs and cause hypertensive crises. They are rare during pregnancy, and a differential diagnosis must be carried out mainly with pregnancy-induced hypertension.

Case: A 27-year-old patient in week 17 of pregnancy admitted to our clinic with hypertension and 45×55 mm heterogeneous nodular lesion in left surrenal. The hospitalized patient had tachycardia and hypertensive episodes despite the treatment. Urinary catecholamine and metanephrine collections revealed elevated norepinephrine and normetanephrine. Magnetic resonance imaging identified a adrenal adenoma. After subsequent pharmacological treatment with alpha and beta blockers, a left adrenalectomy was performed laparoscopically. The histopathological report indicates pheochromocytoma (Pheochromocytoma of the Adrenal gland Scaled Score: 6) and tumor weighing 70 g and measuring 6.5×5.5×3.5 cm. After the surgery urinary catecholamine and metanephrine collections was normal. Postoperatively the patient with 24 weeks gestation had no antihypertensive need.

Conclusion: Pheochromocytoma in pregnancy can cause the death of both the fetus and the mother. This issue should be remembered in hypertensive pregnancies. The approach to the biochemical diagnosis is the same as for the nonpregnant patient. MRI (without gadolinium enhancement) is the preferred imaging modality, and ¹²³I-MIBG is contraindicated. Adrenal pheochromocytomas should be removed promptly if diagnosed during the first or second trimester of pregnancy. In our case, its recognized with new onset hypertention and adrenal tumor was removed in the 2nd trimester.