October - December 2024, Volume 20, Issue 4

Parksook WW, Panumatrassamee K, Phupong V, Snabboon T

Management Strategies for Normotensive Pheochromocytoma in Pregnancy

Acta Endo (Buc) 2024, 20 (4): 533-537
doi: 10.4183/aeb.2024.533

Background. Managing pheochromocytoma during pregnancy presents significant challenges due to the absence of well-established guidelines. Early detection during prenatal care, together with timely medical and surgical interventions, is crucial for achieving favorable maternal and fetal outcomes. Case presentation. This report presents the case of a 35-year-old nulliparous woman with bilateral pheochromocytoma who became pregnant between the first and second stages of adrenalectomy. Preoperative management included α-adrenergic blockade and hydration, which was successfully implemented despite the patient being normotensive. The patient underwent a corticalsparing tumor resection during the second trimester without complications and subsequently delivered a healthy fullterm infant through normal labor. Conclusion. This case demonstrates that preoperative α-adrenergic blockade remains the recommended approach for managing pheochromocytoma during pregnancy, even in normotensive patients. Additionally, laparoscopic cortical-sparing adrenalectomy appears to be an effective surgical option for minimizing the risk of long-term adrenal insufficiency in cases of bilateral lesions.

Keywords: pheochromocytoma, pregnancy, a-adrenergic blocker, cortical-sparing adrenalectomy, pregnancy-induced hypertension.

Correspondence: Thiti Snabboon, M.D., Excellence Center in Diabetes, Hormone and Metabolism, Division of Endocrinology and Metabolism, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Patumwan, Bangkok 10330, Thailand, E-mail: snabboon@yahoo.com