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     ISSN 2149-2042
     e-ISSN 2149-4606
Volume : 36 Issue : 2 Year : 2020

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A Misleading Presentation of Pheochromocytoma in Pregnancy: A Case Report [Medeniyet Med J]
Medeniyet Med J. 2021; 36(1): 69-74 | DOI: 10.5222/MMJ.2021.29660  

A Misleading Presentation of Pheochromocytoma in Pregnancy: A Case Report

Jasmina Begum1, Supriya Kumari1, Manwar Ali2, Saubhagya Kumar Jena1, Kishore behera3, Pritinanda Mishra4
1Department Of Obstetrics And Gynecology, All India Institute Of Medical Sciences, Bhubaneswar, India
2Department Of General Surgery
3Department Of Endocrinology
4Department Of Pathology

Pheochromocytoma is a catecholamine-secreting adrenal tumor and also a rare cause of secondary hypertension in pregnancy. Its low prevalence, nonspecific clinical presentation, and symptoms similar to preeclampsia generate a diagnostic challenge during pregnancy. A 23-year-old hypertensive pregnant woman at 36th gestational week of her first pregnancy was admitted with severe hypertension (210/150 mmHg), headache and proteinuria that made us presume the case as severe preeclampsia. In spite of starting with maximum doses of antihypertensive medications like IV labetolol,and oral nifedipine, loading dose of an anticonvulsant drug, and IV magnesium sulphate, her symptoms persisted. Keeping in view the risks involved to mother and fetus, we delivered the baby by emergency cesarean section. In the postoperative period, along with severe uncontrolled hypertension, she developed tremors, palpitation, and sweating that all led us to further diagnostic workup for secondary causes of hypertension. Eventually, a diagnosis of pheochromocytoma was confirmed by abdominopelvic contrast- enhanced computed tomography and by increased 24-hour urine metanephrine, normetanephrine, and vanillylmandelic acid levels. Subsequently, adrenal suppression was achieved by a multidisciplinary approach, and then she underwent laparoscopic adrenalectomy. This case highlights the importance of maintaining a high index of suspicion and multidisciplinary approach while investigating secondary causes of hypertension in young women, thereby differentiating it from preeclampsia.

Keywords: Pheochromocytoma, pregnancy, secondary hypertension

Jasmina Begum, Supriya Kumari, Manwar Ali, Saubhagya Kumar Jena, Kishore behera, Pritinanda Mishra. A Misleading Presentation of Pheochromocytoma in Pregnancy: A Case Report. Medeniyet Med J. 2021; 36(1): 69-74

Corresponding Author: Jasmina Begum, India

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