2023
DOI: 10.1007/s11154-022-09773-2
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The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy

Abstract: Diagnosis of pheochromocytoma or paraganglioma (PPGL) in pregnancy has been associated historically with high rates of materno-fetal morbidity and mortality. Recent evidence suggests outcomes are improved by recognition of PPGL before or during pregnancy and appropriate medical management with alpha-blockade. Whether antepartum surgery (before the third trimester) is required remains controversial and open to case-based merits. Women with PPGL in pregnancy are more commonly delivered by Caesarean section, alth… Show more

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Cited by 8 publications
(6 citation statements)
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“…The diagnosis of pheochromocytoma is challenging due to its varied clinical manifestations. In addition to various paroxysmal symptoms, such as hypertension, palpitations, sweating, and headache, excessive catecholamines can trigger cardiac arrhythmias, coronary spasms, myocardial infarction [ 1 , 10 ], hemodynamic collapse, heart failure, pulmonary edema, hypotension, and cardiac arrest [ 4 , 11 14 ]. Hypertension is often paroxysmal, as in our reported case; additionally, blood pressure may be unstable [ 2 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The diagnosis of pheochromocytoma is challenging due to its varied clinical manifestations. In addition to various paroxysmal symptoms, such as hypertension, palpitations, sweating, and headache, excessive catecholamines can trigger cardiac arrhythmias, coronary spasms, myocardial infarction [ 1 , 10 ], hemodynamic collapse, heart failure, pulmonary edema, hypotension, and cardiac arrest [ 4 , 11 14 ]. Hypertension is often paroxysmal, as in our reported case; additionally, blood pressure may be unstable [ 2 ].…”
Section: Discussionmentioning
confidence: 99%
“…The ambiguous presentation of pheochromocytomas is frequently misinterpreted as preeclampsia. Although rare in pregnant women [ 2 4 ], pheochromocytomas pose a high risk of maternal and fetal death if not appropriately managed [ 5 ]. This case report describes a pregnant woman with a pheochromocytoma who underwent a cesarean section.…”
Section: Introductionmentioning
confidence: 99%
“…Pc is, in fact, a rare cause of hypertension but should always be taken into consideration as a differential diagnosis in hypertensive pregnant women, especially in absence of proteinuria and/or onset before the 20th gestational week [ 22 , 23 ]. A number of described cases suggest that it is safe to resect Pcs either during late first or early second trimester [ 24 ], or at full-term pregnancy, either with concurrent tumor removal and caesarean section or postponed surgery after delivery [ 12 , 25 ]. The rarity of this disease makes a prospective, randomized trial impossible to conduct but repeated reviews of large cohorts have come to similar conclusions without finding any significant difference in mortality when comparing early and late tumor resection [ 6 , 26 ], in line with the findings of the current study.…”
Section: Discussionmentioning
confidence: 99%
“…The diagnosis should also be suspected in the context of therapy-resistant hypertension, although there are no vasomotor disorders. Other symptoms are not so obvious: ascending constrictive abdomino-thoracic pain, anxiety, tremors, pallor and digestive disorders [ 9 ]. Biology allows the diagnosis to be established by measuring catecholamines (adrenaline, noradrenaline, dopamine) in the blood or urine, and their urinary metabolites (metanephrine, normetanephrine and vanylmandelic acid (VMA), which remain unchanged by pregnancy [ 10 , 11 ].…”
Section: Discussionmentioning
confidence: 99%
“…Ultrasound, which has a sensitivity of 89–97 % for adrenal locations outside of pregnancy, does not allow exploration of the mediastinum and is technically difficult in late pregnancy [ [7] , [8] , [9] , [10] ]. Computed-tomography is feasible, but magnetic resonance imaging is the reference examination during pregnancy, as it is non-irradiating and very sensitive.…”
Section: Discussionmentioning
confidence: 99%