Surgical treatment of adrenal tumors during pregnancy

Bartz-Kurycki, Marisa A.; Dream, Sophie; Wang, Tracy

doi:10.1007/s11154-022-09744-7

Cited by 5 publications

(2 citation statements)

References 95 publications

(173 reference statements)

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“…Many reports highlight the clinical challenge of treating adrenal tumours during pregnancy. Surgical intervention is typically prioritised as the primary treatment approach [ 30 ]. However, medical treatment can be considered as a secondary therapeutic option in cases where surgery is contraindicated, unsuccessful or declined by the patient.…”

Section: Discussionmentioning

confidence: 99%

“…PRA offers potential benefits for pregnant patients due to no chance of injuring the uterus. It requires the gravid patient to be at a lateral decubitus position, which relieves uterine compression on the vena cava and results in enhanced oxygenation and improved systolic blood pressure [ 30 ]. However, the optimal timing for adrenalectomy remains uncertain due to the limited literature and a lack of consensus.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Wang,

An,

Hou

et al. 2024

Endocrino Diabet & Metabol

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PurposeTo present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes.MethodsWe describe five pregnant women with CS, detailing clinical presentations and laboratory findings.ResultsCommon clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas.ConclusionDiagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Wang,

An,

Hou

et al. 2024

Endocrino Diabet & Metabol

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Pregnancy in patients with adrenocortical carcinoma: a case-based discussion

Puglisi

Basile

Sperone

et al. 2022

Rev Endocr Metab Disord

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Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

Gunnesson,

Ragnarsson,

Nilsson

et al. 2024

Endocrine

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Purpose Data guiding management of pheochromocytoma and paraganglioma (PPGL) in pregnant women is limited, and long-term effects on the child are unknown. The aim of this retrospective registry-based case-cohort study was to assess how maternal PPGL and treatment impacts maternal and fetal outcome, including long-term outcome for the child. The main outcomes were maternal and fetal mortality and morbidity at delivery and relative healthcare consumption in children born by mothers with PPGL during pregnancy. Methods The National Birth Register identified 4,390,869 pregnancies between 1973–2015. Data was crosslinked with three Swedish national registers to identify women diagnosed with pheochromocytoma or paraganglioma within one year before or after childbirth. Hospital records were reviewed and register data was collected for five age-matched controls for each child until age 18. Results 21 women and 23 children were identified (incidence 4.8/1.000.000 births/year), all women with adrenal pheochromocytomas (Pc). The majority (71%) were diagnosed post-partum. Nine women (43%) were hypertensive during pregnancy. Preterm delivery was more common in Pc patients compared to controls (30% vs 6%, p < 0.001). There was no maternal or fetal mortality. Timing of tumor removal did not affect gestational weight or APGAR scores. There was no observed difference in hospital admissions between children affected by maternal Pc and controls. Conclusion Pc was commonly diagnosed after delivery and raised the risk of pre-term delivery, suggesting a need for an increased awareness of this diagnosis. However, reassuringly, there was no fetal or maternal mortality or any observed long-term impact on the children.

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Surgical treatment of adrenal tumors during pregnancy

Cited by 5 publications

References 95 publications

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Pregnancy in patients with adrenocortical carcinoma: a case-based discussion

Maternal pheochromocytoma and childbirth in Sweden 1973–2015: a population-based study on short and long-term outcome

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