A nine-weeks pregnant, 27-year-old female was admitted for hypertension with a blood pressure of 213/110 mm Hg, headaches, palpitations, and anxiety. There was no previous history of hypertension or pre-eclampsia. She had elevated urinary normetanephrine, plasma-free normetanephrine, and plasma-free metanephrine concentrations. Phenoxybenzamine and labetalol were initiated for presumed pheochromocytoma. At thirteen weeks of pregnancy, a noncontrast magnetic resonance imaging (MRI) of the abdomen failed to identify an adrenal or extra-adrenal mass. At 21-weeks gestation, an abdominal [18-F]-fluorodeoxyglucose positron emission tomography with computed tomography demonstrated an extra-adrenal lesion. The patient underwent a laparotomy during the second trimester with successful removal of a benign paraganglioma.
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