Phaeochromocytoma in early pregnancy: A case report and review of the literature.

Authors

  • V. K. Oriji
  • P. O. Fiebai
  • A. Iyagba

Keywords:

Phaeochromocytoma, early pregnancy, hypertension, catecholamines, chromaffin tumors

Abstract

Phaeochromocytomas are rare neuroendocrine tumors of the adrenal. They are a very rare cause of secondary hypertension. They are very rare in pregnancy and much more so in early pregnancy. In this narrative review, we conducted a MEDLINE search of review articles on phaeochromocytoma from 2000 to 2018 using the key words “phaeochromocytoma, early pregnancy, hypertension, catecholamines, and chromaffin tumors. We identified relevant articles and also looked up key references. We also highlight the challenges and limitations of our management experience in our practice setting. Although phaeochromocytomas are very rare in early pregnancy, a high index of suspicion is needed to make this diagnosis. Otherwise, it may be misdiagnosed as pregnancy induced or related hypertension.

References

Eisenhofer G, Siegert G, Kotzerke J, Bornstein SR, Pacak K. Current progress and future challenges in the biochemical diagnosis and treatment of pheochromocytomas and paragangliomas. Hormone and Metabolic Research. 2008; 40(05):329-37.

Lenders JW, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. The Lancet. 2005 20; 366(9486):665-75.

Mansmann G, Lau J, Balk E, Rothberg M, Miyachi Y, Bornstein SR. The clinically inapparent adrenal mass: update in diagnosis and management. Endocrine Reviews. 2004;

(2):309-40.

Braunstein GD. Management of the clinically inapparent adrenal mass. Annals of Internal Medicine. 2004; 140(5):401-2.

Melvin MGB. Management of the clinically inapparent adrenal mass. Annals of Internal Medicine. 2003; 138(5):424-9.

Dugas G, Fuller J, Singh S, Watson J.

Pheochromocytoma and pregnancy: a case report and review of anesthetic management. Canadian Journal of Anesthesia. 2004; 51(2):134-8

Sheps SG, Jiang NS, Klee GG. Diagnostic evaluation of pheochromocytoma.

Endocrinology and Metabolism Clinics of North America. 1988; 17(2):397-414.

Reisch N, Peczkowska M, Januszewicz A, Neumann HP. Pheochromocytoma: presentation, diagnosis and treatment. Journal of

Hypertension. 2006; 24(12):2331-9.

Oliva R, Angelos P, Kaplan E, Bakris G. Pheochromocytoma in pregnancy: a case series and review. Hypertension. 2010; 55(3):600-6.

Sarathi V, Bandgar TR, Menon PS, Shah NS. Pheochromocytoma and medullary thyroid carcinoma in a pregnant multiple endocrine neoplasia-2A patient. Gynecological

Endocrinology. 2011; 27(8):533-5.

Chen H, Sippel RS, O'dorisio MS, Vinik AI, Lloyd RV, Pacak K. The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas. 2010; 39(6):775-83.

Neumann HP, Bausch B, McWhinney SR,

Bender BU, Gimm O, Franke G, et al. Germ-line mutations in nonsyndromic pheochromocytoma. New England Journal of Medicine. 2002; 346(19):1459-66.

Neumann H, Berger DP, Sigmund G, Blum U,

S c h m i d t D , P a r m e r R J , e t a l .

Pheochromocytomas, multiple endocrine neoplasia type 2, and von Hippel-Lindau disease. New England Journal of Medicine. 1993; 329(21):1531-8.

Proye C, Fossati P, Fontaine P, Lefebvre J, Decoulx M, Wemeau JL, et al. Dopaminesecreting pheochromocytoma: an unrecognized entity? Classification of pheochromocytomas according to their type of secretion. Surgery. 1986; 100(6):1154-62.

Bergland BE. Pheochromocytoma presenting as shock. The American Journal of Emergency Medicine. 1989; 7(1):44-8.

Manger WM. The protean manifestations of pheochromocytoma. Hormone and metabolic research. 2009;41(09):658-63.

Goldfarb DA, Novick AC. Detecting and managing pheochromocytoma. Contemporary Obstetrics and Gynaecology. 1997; 42:70-80.

Francis IR, Korobkin M. Pheochromocytoma.

Radiology Clinics North America 1996; 34(6):1101-12.

Pacak K, Linehan WM, Eisenhofer G, Walther MM, Goldstein DS. Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Annals of Internal

Medicine. 2001; 134(4):315-29.

Prys-Roberts C. Phaeochromocytoma-recent progress in its management. British Journal of Anaesthesia. 2000; 85(1):44-57.

Lenders JW. Endocrine disorders in pregnancy: pheochromocytoma and pregnancy: a deceptive connection. European Journal of Endocrinology. 2012; 166(2):143-50.

Afuwape O, Ladipo JK, Ogun O, Adeleye J, Irabor D. Pheochromocytoma in an accessory adrenal gland: a case report. Cases Journal. 2009; 2(1):6271.

Omoniyi-Esan GO, Sabageh D, Badmus KB, Orji EO, Rotimi O. Pheochromocytoma in pregnancy: an unusual presentation and review of literature. Journal Chinese Clinical Medicine 2008; 3(5): 297-300.

Domi R, Laho H. Management of pheochromocytoma: old ideas and new drugs. Nigerian Journal of Clinical Practice. 2012; 15(3):253-7.

Kondziella D, Lycke J, Szentgyörgyi E. A diagnosis not to miss: pheochromocytoma during pregnancy. Journal of Neurology. 2007; 254(11):1612-3.

Brain KL, Kay J, Shine B. Measurement of urinary metanephrines to screen for pheochromocytoma in an unselected hospital referral population. Clinical Chemistry. 2006; 52(11):2060-4.

Manger WM, Eisenhofer G. Pheochromocytoma: diagnosis and management update. Current Hypertension Reports. 2004; 6(6):477-84.

Kudva YC, Sawka AM, Young Jr WF. The l a b o r a t o r y d i a g n o s i s o f a d r e n a l pheochromocytoma: the Mayo Clinic experience. The Journal of Clinical Endocrinology & Metabolism. 2003;

(10):4533-9.

Lyman DJ. Paroxysmal hypertension, pheochromocytoma, and pregnancy. The Journal of the American Board of Family Practice. 2002; 15(2):153-8.

Syed AA, Wheatley HA, Badminton MN, McDowell IF. Urinary catecholamines and metabolites in the immediate postoperative period following major surgery. Journal of Clinical Pathology. 2004; 57(5):548-50.

Elsayes KM, Mukundan G, Narra VR, Lewis Jr JS, Shirkhoda A, Farooki A, Brown JJ. Adrenal masses: MR imaging features with pathologic correlation. Radiographics. 2004; 24(Suppl 1): S73-86.

Elsayes KM, Narra VR, Leyendecker JR, Francis IR, Lewis Jr JS, Brown JJ. MRI of adrenal and extraadrenal pheochromocytoma. American Journal of Roentgenology. 2005; 184(3):860-7.

Bravo EL. Evolving concepts in the pathophysiology, diagnosis, and treatment of pheochromocytoma. Endocrine Reviews. 1994; 15(3):356-68.

Park BK, Kim CK, Kwon GY, Kim JH. Reevaluation of pheochromocytomas on delayed contrast-enhanced CT: washout enhancement and other imaging features. European Radiology. 2007; 17(11):2804-9.

Ismail NA, Rahman RA, Wahab NA, Muhammad

R, Azmi KN. Pheochromocytoma and

Pregnancy: A Difficult and Dangerous Ordeal. The Malaysian Journal of Medical Sciences. 2012; 19(1):65.

Jaques S, Tobes MC, Sisson JC. Sodium dependency of uptake of norepinephrine and miodobenzylguanidine into cultured human pheochromocytoma cells: evidence for uptakeone. Cancer Research. 1987; 47(15):3920-8.

Ilias I, Pacak K. Current approaches and recommended algorithm for the diagnostic localization of pheochromocytoma. Journal of Clinical Endocrinology and Metabolism 2004; 89:479-491.

Beierwaltes WH. Endocrine imaging: parathyroid, adrenal cortex and medulla, and other endocrine tumors: part II. Journal of Nuclear Medicine 1991; 32:1627-1639.

Havekes B, Lai EW, Corssmit EP, Romijn JA, Timmers HJ, Pacak K. Detection and treatment of pheochromocytomas and paragangliomas: current standing of MIBG scintigraphy and future role of PET imaging. The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2008; 52:419-429.

Ilias I, Pacak K. Current approaches and recommended algorithm for the diagnostic localization of pheochromocytoma. Journal of Clinical Endocrinology and Metabolism. 2004; 89(2):479-91.

Lebuffe G, Dosseh ED, Tek G, Tytgat H, Moreno S, Tavernier B, et al. The effect of calcium channel blockers on outcome following the surgical treatment of phaeochromocytomas and

paragangliomas. Anaesthesia. 2005; 60(5):43944.

Cubeddu LX, Zarate NA, Rosales CB, Zschaeck DW. Prazosin and propranolol in preoperative management of pheochromocytoma. Clinical

Pharmacology and Therapeutics. 1982;

(2):156-60.

James MF. Use of magnesium sulphate in the a n a e s t h e t i c m a n a g e m e n t o f phaeochromocytoma: a review of 17 anaesthetics. BJA: British Journal of Anaesthesia. 1989; 62(6):616-23.

Toniato A, Boschin IM, Opocher G, Guolo A, Pelizzo M, Mantero F. Is the laparoscopic adrenalectomy for pheochromocytoma the best treatment? Surgery. 2007; 141(6):723-7.

Kercher KW, Novitsky YW, Park A, Matthews BD, Litwin DE, Heniford BT. Laparoscopic curative resection of pheochromocytomas. Annals of Surgery. 2005; 241(6):919.

Guerrero MA, Schreinemakers JM, Vriens MR, Suh I, Hwang J, Shen WT, Gosnell J, et al. Clinical spectrum of pheochromocytoma. Journal of the American College of Surgeons. 2009; 209(6):727-32.

Pacak K, Eisenhofer G, Ahlman H, Bornstein SR, Gimenez-Roqueplo AP, Grossman AB, et al. Pheochromocytoma: recommendations for clinical practice from the First International Symposium. Nature Reviews Endocrinology. 2007; 3(2):92-102.

Jude EB, Sridhar CB. Prolonged hypoglycaemia f o l l o w i n g s u r g i c a l r e m o v a l o f

phaeochromocytoma. Postgraduate Medical Journal. 2000; 76(891):39-40.

Lau P, Permezel M, Dawson P, Chester S, Collier N, Forbes I. Phaeochromocytoma in pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology. 1996; 36(4):472-6.

Sarathi V, Lila A, Bandgar T, Menon P, Shah N. Pheochromocytoma and pregnancy: a rare but dangerous combination. Endocrine Practice. 2009; 16(2):300-9.

Lenders JW. Endocrine disorders in pregnancy: pheochromocytoma and pregnancy: a deceptive connection. European Journal of Endocrinology. 2012; 166(2):143-50.

Lin WY, Gao HW, Hwang KS, Chu KM, Liou JT.

D a n g e r o u s P i t f a l l : P e r i p a r t u m Pheochromocytoma Mimicking Severe Preeclampsia. Acta Cardiologica Sinica. 2010;

: 259-63

Downloads

Published

2023-10-08

How to Cite

Oriji, V. K., Fiebai, P. O., & Iyagba, A. (2023). Phaeochromocytoma in early pregnancy: A case report and review of the literature. Research Journal of Health Sciences, 7(3), 186–193. Retrieved from https://rjhs.org/index.php/home/article/view/214