EYES2024 ESE Young Endocrinologists and Scientists (EYES) 2024 Adrenals and Neuroendocrine Tumors (17 abstracts)
Pheochromocytoma diagnosed during pregnancy – a case report
Bruna Pimentel 1 , Inês Neves 2 , Mariana Araújo 3 , Pedro Ferreira 4 , Rita Roque 5 , Diogo Bruno 3 , Clara Cunha 1 & João Sequeira Duarte 1
1Department of Endocrinology, Diabetes and Metabolism, Egas Moniz Hospital, Lisbon, Portugal; 2Departament of Anesthesiology, São Francisco Xavier Hospital, Lisbon, Portugal; 3Department of Gynecology and Obstetrics, São Francisco Xavier Hospital, Lisbon, Portugal; 4Department of Radiology, Egas Moniz Hospital, Lisbon, Portugal; 5Department of General Surgery, Santa Cruz Hospital, Lisbon, Portugal
Introduction: In pregnancy, pheochromocytoma is an extremely rare clinical condition. If undiagnosed and nontreated, it’s associated with adverse maternal-fetal outcomes. An early diagnosis and the prevention of a hypertensive crisis during delivery and surgical treatment are of the utmost importance in the management of a pheochromocytoma during pregnancy.
Case report: We report the case of a 41-year-old female diagnosed with pheochromocytoma during pregnancy at week 36 of gestation. She presented with episodes of headache, palpitations, sweating and paroxysmal hypertension. She previously had hypertensive crisis after surgical procedures (myomectomy, c-section). Blood tests showed elevated plasmatic and urinary metanephrines (6-fold above normal cut-offs). MRI revealed a left adrenal mass with 3,7 × 2.5 × 2 cm suggestive of a pheocromocytoma. A C-section was performed after 7 days of α-blockade with phenoxybenzamine (37 weeks of gestation) and she underwent laparoscopic left adrenalectomy 2 weeks post-partum. The pathology study confirmed the diagnosis. Post-surgical study showed normal metanephrines. Genetic study is underway.
Discussion and conclusion: The management of pheochromocytoma during pregnancy is challenging: optimum timing of surgery, preferred route and timing of delivery and type of α-adrenergic receptor blockers during pregnancy are not consensual. Decisions should be made on an individual basis. Our case demonstrates that a multidisciplinary approach to adopt the right pre and post-operative treatment, improves both maternal and fetal outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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