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Exp Clin Endocrinol Diabetes 2004; 112(2): 98-101
DOI: 10.1055/s-2004-815764
Article

J. A. Barth Verlag in Georg Thieme Verlag Stuttgart · New York

Pheochromocytoma during Pregnancy: Laparoscopic and Conventional Surgical Treatment of Two Cases

A. Wolf1 , P. E. Goretzki1 , A. Röhrborn1 , J. Feldkamp2 , D. Simon1 , W. A. Scherbaum2 , H.-D. Röher1
  • 1Department of General and Visceral Surgery, Heinrich Heine University, Düsseldorf, Germany
  • 2Department of Endocrinology and Internal Medicine, Heinrich Heine University, Düsseldorf, Germany
Further Information

Publication History

Received: July 2, 2002 First decision: February 24, 2003

Accepted: July 14, 2003

Publication Date:
19 March 2004 (online)

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Abstract

Pheochromocytoma is a rare entity. When it presents during pregnancy, rapid recognition and diagnosis are crucial in order to avoid the maternal and fetal morbidity and mortality associated with severe, uncontrolled hypertension. Difficulties arise from the differential diagnosis of pre-eclampsia. We report two patients operated on for pheochromocytoma during pregnancy. The first patient developed new-onset hypertension in early pregnancy. Prior to presentation, there had been non-specific signs of endocrine disorder, namely a mild diabetes, but no hypertension requiring medication. The second patient sought medical care for irregular heartbeat, shortness of breath, and fatigue during the 6th week of pregnancy. She was found to be hypertensive; diagnostic evaluation revealed substantially increased catecholamine levels. The diagnosis was made by elevated urinary catecholamines and by MRI scan as well as ultrasonography, both of which demonstrated an adrenal mass.

Both patients underwent surgical extirpation of the affected adrenal gland. The procedure was performed laparoscopically in the case of the second patient. Pre-operatively, both patients were pre-treated with α-blockade followed by secondary β-blockade. Patient two also received methyldopa for control of hypertension. Both patients were readily weaned from antihypertensive medications post-operatively, with complete resolution of hypertension within a few hours. Each pregnancy progressed normally to term.

Key words

Pheochromocytoma - pregnancy - pre-eclampsia - laparoscopy

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Dr. med. A. Wolf

Klinik für Allgemein- und Unfallchirurgie, Heinrich Heine Universität

Moorenstraße 5

40225 Düsseldorf

Germany

Phone: + 492118117351

Fax: + 49 21 18 11 73 59

Email: roehrborn@med.uni-duesseldorf.de

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