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Conservative Management of Extra-Adrenal Pheochromocytoma During Pregnancy

Miller, Caela MD*; Bernet, Victor MD; Elkas, John C. MD; Dainty, Louis MD; Gherman, Robert B. MD*

doi: 10.1097/01.AOG.0000141555.91842.c2
Case Reports

BACKGROUND: Extra-adrenal pheochromocytomas are catecholamine-secreting tumors that arise from chromaffin cells of the paraganglion sympathetic system. All of the previously reported cases have described surgical resection during the antepartum period.

CASE: At 14 weeks of gestation, a multiparous patient was diagnosed with an extra-adrenal dopaminergic pheochromocytoma. A decision was made to delay surgical intervention until the postpartum period. Phenoxybenzamine, 10 mg per day, was subsequently started. At 35 + 2 weeks of gestation, the patient delivered a 2,600 g infant via an uncomplicated cesarean. Three weeks later, the extra-adrenal pheochromocytoma was removed, and she also underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and rectosigmoid resection with end-to-end colostomy.

CONCLUSION: Conservative management of dopaminergic-secreting extra-adrenal pheochromocytomas can result in favorable maternal and fetal outcomes.

Dopaminergic extra-adrenal pheochromocytomas may be managed conservatively during pregnancy.

*Department of Obstetrics and Gynecology, Division of Maternal/Fetal Medicine, National Naval Medical Center, Bethesda, Maryland; †Department of Medicine, Endocrinology, Diabetes and Metabolism Service, Walter Reed Army Medical Center, Washington, DC; and ‡Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center, Washington, DC

Received March 23, 2004. Received in revised form April 30, 2004. Accepted May 7, 2004.

Reprints are not available. Address correspondence to: Robert B. Gherman, MD, Department of OB/GYN, Division of Maternal/Fetal Medicine, National Naval Medical Center, Bethesda Naval Hospital, Bethesda, MD 20889; e-mail:

The views expressed in this article are those of the authors and do not reflect the official position of the Department of Defense, Departments of the Navy, Army, Air Force, or the United States Government.

© 2005 The American College of Obstetricians and Gynecologists