Pheochromocytoma and Pregnancy

Endocrinol Metab Clin North Am. 2019 Sep;48(3):605-617. doi: 10.1016/j.ecl.2019.05.006. Epub 2019 Jun 13.

Abstract

Pheochromocytoma during pregnancy, although rare, is a perilous condition. The wellbeing of mother and fetus are at stake if not diagnosed and treated antenatally and timely. The diagnosis is frequently overlooked because of the aspecific nature of signs and symptoms and confusion with pregnancy-related hypertension. Measurements of plasma or urinary free metanephrines have the highest diagnostic accuracy. MRI is preferred over ultrasonography. The optimal time for surgical removal is before 24 weeks of gestation or at/after delivery. Laparoscopic adrenalectomy should be preceded by medical pretreatment. Cesarean delivery is preferred in these patients; vaginal delivery might be considered in selected pretreated patients.

Keywords: Catecholamines; Metanephrines; Paraganglioma; Pheochromocytoma; Pregnancy.

Publication types

  • Review

MeSH terms

  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / therapy
  • Adrenalectomy / methods
  • Adrenalectomy / standards
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Metanephrine / blood
  • Metanephrine / urine
  • Pheochromocytoma* / diagnosis
  • Pheochromocytoma* / therapy
  • Pregnancy
  • Pregnancy Complications, Neoplastic*
  • Ultrasonography

Substances

  • Metanephrine