Laparoscopic adrenalectomy for pheochromocytoma in pregnancy.

摘要

A 28-year-old woman was diagnosed with right adrenal pheochromocytoma on the basis of episodes of nausea, bloating and headaches, and elevated 24-hour urine metanephrines, normetanephrines and epinephrine. Imaging studies included ultrasonography, computed tomography and a rnetaiodobenzylguani-dine (MIBG) scan. Serum calcium, calcitonin, renin and aldosterone levels were normal, as were the results of a low-dose dexamethasone test and a thyroid-stimulating hormone test. Genetic testing for multiple endocrine neoplasia, type 2 and von Hippel-Lindau disease was negative. Two weeks after the diagnosis, the patient discovered that she was pregnant. She was subsequently taken off prazosin and referred to both an obstetrician who specialized in high-risk pregnancy and a laparoscopic surgeon. The patient underwent an uncomplicated laparoscopic right adrenalectomy at 16 weeks' gestation. This led to resolution of symptoms and biochemical abnormalities and delivery of a healthy son at term. Pathological analysis confirmed the diagnosis of pheochromocytoma with minimal cy-tological pleomorphism and no extension outside the adrenal gland; these findings are consistent with the presence of a benign lesion.