Skip to main content
SpringerLink
Log in

Diagnosis and management of pheochromocytoma during pregnancy

  • Review Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Although the presence of pheochro-mocytoma in pregnancy is extremely rare, this association deserves much attention as the tumor constitutes a very high risk for both mother and fetus. Any pregnant woman with hypertension, especially if paroxysmal or labile, or with so far unexplained “spells”, should induce the clinician to consider the possibility of a pheochromocytoma. Maternal and fetal survival depend a lot on an early diagnosis, a correct medical therapy and a correct timing of delivery and surgery. In this respect, a strict collaboration between obstetricians, endocrinologists, anesthesiologists and surgeons is pivotal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Manger W.M., Gifford R.W.J. Phaeochromocytoma. Springer-Verlag, New York, 1977, p. 1.

    Book  Google Scholar 

  2. Harrington J.L., Farley D.R., van Heerden J.A., Ramin K.D. Adrenal tumors and pregnancy. World J. Surg. 1999, 23: 182–186.

    Article  PubMed  CAS  Google Scholar 

  3. Brunt L.M. Phaeochromocytoma in pregnancy. Br. J. Surg. 2001, 88: 481–483.

    Article  PubMed  CAS  Google Scholar 

  4. Schenker J.G., Chowers I. Pheochromocytoma and pregnancy. Review of 89 cases. Obstet. Gynaecol. Surv. 1971, 26: 739–747.

    Article  CAS  Google Scholar 

  5. Schenker J.G., Granat M. Pheochromocytoma and pregnancy. An updated appraisal. Aus. N. Z. J. Obstet. Gynaecol. 1982, 22: 1–10.

    Article  CAS  Google Scholar 

  6. Harper M.A., Murnaghan G.A., Kennedy L., Hadden D.R., Atkinson A.B. Pheochromocytoma in pregnancy. Five cases and a review of the literature. Br. J. Obstet. Gynaecol. 1989, 96: 594–606.

    Article  PubMed  CAS  Google Scholar 

  7. Ahlawat S.K., Jain S., Kumari S., Varma S., Sharma B.K. Pheochromocytoma associated with pregnancy: case report and review of the literature. Obstet. Gynecol. Surv. 1999, 54: 728–737.

    Article  PubMed  CAS  Google Scholar 

  8. Van der Vaart C.H., Heringa M.P., Dullaart R., Aarnoudse J.G. Multiple endocrine neoplasia presenting as pheochro-mocytoma during pregnancy. Br. J. Obstet. Gynaecol. 1993, 100: 1144–1145.

    Article  PubMed  Google Scholar 

  9. Hamilton A., Sirrs S., Schmidt N., Onrot J. Anaesthesia for phaeochromocytoma in pregnancy. Can. J. Anaesth. 1997, 44: 654–657.

    Article  PubMed  CAS  Google Scholar 

  10. Takai Y., Seki H., Kinoshita K. Pheochromocytoma in pregnancy manifesting hypertensive crisis induced by meto-colpramide. Int. J. Gynaecol. Obstet. 1997, 59: 133–137.

    Article  PubMed  CAS  Google Scholar 

  11. Chittacharoen A., Phuapradit W. Pheochromocytoma during pregnancy: case report. J. Obstet. Gynaecol. Res. 1997, 23: 209–212.

    Article  PubMed  CAS  Google Scholar 

  12. Lam J., Henriquez R., Cruzat C. Pheochromocytoma and von Recklinghausen neurofibromatosis: post-partum crisis and renal artery thrombosis. Rev. Med. Chil. 1998, 126: 1367–1371.

    PubMed  CAS  Google Scholar 

  13. Takahashi K., Sai Y., Nosaka S. Anaesthetic management for caesarean section combined with removal of phaeo-chromocytoma. Eur. J. Anaesthesiol. 1998, 15: 364–366.

    Article  PubMed  CAS  Google Scholar 

  14. Bailit J., Neerhof M. Diagnosis and management of pheochromocytoma in pregnancy: a case report. Am. J. Perinatol. 1998, 15: 259–262.

    Article  PubMed  CAS  Google Scholar 

  15. Kim H.J., Kim D.K., Lee S.C., Yang J.H., Lee W.R. Pheochromocytoma complicated with cardiomyopathy after delivery- a case report and literature review. Korean J. Intern. Med. 1998, 13: 117–122. (Review).

    PubMed  CAS  Google Scholar 

  16. Serleth H.J., Cogbill T.H., Gundersen III S.B. Ruptured pan-creaticoduodenal artery aneurysms and pheochromocy-toma in a pregnant patient with neurofibromatosis. Surgery 1998, 124: 100–102.

    Article  PubMed  CAS  Google Scholar 

  17. Demeure M.J., Carlsen B., Traul D., et al. Laparoscopic removal of a right adrenal pheochromocytoma in a pregnant woman. J. Laparoendosc. Adv. Surg. Tech. A. 1998, 8: 315–319.

    Article  PubMed  CAS  Google Scholar 

  18. Del Giudice A., Bisceglia M., D’Errico M., et al. Extra-adrenal functional paraganglioma (phaeochromocytoma) associated with renal-artery stenosis in a pregnant woman. Nephrol. Dial. Transplant. 1998, 13: 2920–2923.

    Article  PubMed  Google Scholar 

  19. Kothari A., Bethune M., Manwaring J., Astley N., Wallace E. Massive bilateral phaeochromocytomas in association with Von Hippel Lindau syndrome in pregnancy. Aust. N. Z. J. Obstet. Gynaecol. 1999, 39: 381–384.

    Article  PubMed  CAS  Google Scholar 

  20. Michalski U., Bauer W., Gojowczyk R., Lochle C., Pross E. A rare differential diagnosis of a pregnancy gestosis. Dtsch. Med. Wochenschr. 1999, 124: 1164–1167.

    Article  PubMed  CAS  Google Scholar 

  21. Finkenstedt G., Gasser R.W., Höfle G., et al. Pheochromocytoma and sub-clinical Cushing’s syndrome during pregnancy: diagnosis, medical pre-treatment and cure by laparoscopic unilateral adrenalectomy. J. Endocrinol. Invest. 1999, 22: 551–557.

    Article  PubMed  CAS  Google Scholar 

  22. Zangrillo A., Valentini G., Casati A., Torri G. Myocardial infarction and death after caesarean section in a woman with protein S deficiency and undiagnosed phaeochromocytoma. Eur. J. Anaesthesiol. 1999, 16: 268–270.

    Article  PubMed  CAS  Google Scholar 

  23. Remmel E., Oertli D., Holzgreve W., Hosli I., Staub J.J., Harder F. Malignant pheochromocytoma in the 17th week of gestation. Chirurgie 1999, 70: 1053–1057.

    Article  CAS  Google Scholar 

  24. Bullough A.S., Karadia S., Watters M. Phaeochromocytoma: an unusual cause of hypertension in pregnancy. Anaesthesia 2001, 56: 43–46.

    Article  PubMed  CAS  Google Scholar 

  25. Kuvacic I., Kalafatic D., Skrablin S., et al. Pheochromocytoma with negative urinalysis in pregnancy. Croat. Med. J. 2000, 41: 96–98.

    PubMed  CAS  Google Scholar 

  26. Strachan A.N., Claydon P., Caunt J.A. Phaeochromocytoma diagnosed during labour. Br. J. Anaesth. 2000, 85: 635–637.

    Article  PubMed  CAS  Google Scholar 

  27. Pickering T.G., Isom O.W., Bergman G.W., Barbieri J.M. Pheochromocytoma of the heart. Am. J. Cardiol. 2000, 86: 1288–1289.

    Article  PubMed  CAS  Google Scholar 

  28. Barzel U.S., Barllan Z., Runmery G., Lazebro K.Y., Eckerling B., De Vries A. Pheochromocytoma and pregnancy. Am. J. Obstet. Gynecol. 1964, 89: 519–521.

    PubMed  CAS  Google Scholar 

  29. Dahia P.L.M., Hayashida C.Y., Strunz C., Abelin N., Toledo S.P. Low cord blood levels of catecholamine from a newborn of a pheochromocytoma patient. Eur. J. Endocrinol. 1994, 130: 217–221.

    Article  PubMed  CAS  Google Scholar 

  30. Greiss F.C. Jr., Anderson S.C., King L.C. Uterine vascular bed: effect of acute hypoxia. Am. J. Obstet. Gynecol. 1972, 113: 1057–1064.

    PubMed  Google Scholar 

  31. Bakri Y.N., Ingermansson S.E., Ali A., Parikh S. Pheochromocytoma and pregnancy: report of three cases. Acta Obstet. Gynecol. Scand. 1992, 71: 301–304.

    Article  PubMed  CAS  Google Scholar 

  32. Mannelli M., Ianni L., Cilotti A., Conti A. Pheochromo-cytoma in Italy: a multicentric retrospective study. Eur. J. Endocrinol. 1999, 141: 619–624.

    Article  PubMed  CAS  Google Scholar 

  33. Jaffe R.B., Marrinson T.S., Geny J.G. Localization of meta-static pheochromocytoma in pregnancy by catheterization Am. J. Obstet. Gynecol. 1969, 104: 939–944.

    CAS  Google Scholar 

  34. Lenders J.W., Keiser H.R., Goldstein D.S., Willemsen J.J., Friberg P., Jacobs M.C. Plasma metanephrines in the diagnosis of pheochromocytoma. pAnn. Int. Med. 1995, 123: 101–109.

    CAS  Google Scholar 

  35. Mannelli M., De Feo M.L., Maggi M., et al. Usefulness of basal catecholamine plasma levels and clonidine suppression test in the diagnosis of pheochromocytoma. J. Endocrinol. Invest. 1987, 10: 377–382.

    Article  PubMed  CAS  Google Scholar 

  36. Mannelli M. Diagnostic problems in pheochromocytoma. J. Endocrinol. Invest. 1989, 12: 739–757.

    Article  PubMed  CAS  Google Scholar 

  37. Freier D.T., Thomson N.W. Pheochromocytoma and pregnancy: the epitome of high risk. Surgery 1993, 114: 1148–1152.

    PubMed  CAS  Google Scholar 

  38. Wheeler M.H., Chare M.J.B., Austin T.R., Lazarus J.H. The management of the patient with catecholamines excess. World J. Surg. 1982, 6: 735–747.

    Article  PubMed  CAS  Google Scholar 

  39. Botchan A., Hauser R., Kupferminc M., Grisaru D., Peyser M.R., Lessing J.B. Pheochromocytoma in pregnancy: case report and review of the literature. Obstet. Gynecol. Surv. 1995, 50: 321–327.

    Article  PubMed  CAS  Google Scholar 

  40. Gagner M., Breton G., Pharand D., Pomp A. Is laparoscopic adrenalectomy indicated for pheochromocytomas? Surgery, 1996, 120: 1076–1080.

    Article  PubMed  CAS  Google Scholar 

  41. De Perrot M., Jenny A., Morales M., Kohlik M., Morel P. Laparoscopic appendectomy during pregnancy. Surg. Laparosc. Endosc. Percutan. Tech. 2000, 10: 368–371.

    PubMed  Google Scholar 

  42. Fatum M., Rojansky N. Laparoscopic surgery during pregnancy. Obstet. Gynecol. Surv. 2001, 56: 50–59.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Pathophysiology, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy

    M. Mannelli & D. Bemporad

Authors
  1. M. Mannelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Bemporad
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Mannelli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mannelli, M., Bemporad, D. Diagnosis and management of pheochromocytoma during pregnancy. J Endocrinol Invest 25, 567–571 (2002). https://doi.org/10.1007/BF03345503

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03345503

Key-words

Search

Navigation