MANAGEMENT STRATEGIES FOR NORMOTENSIVE PHEOCHROMOCYTOMA IN PREGNANCY.
W W Parksook, K Panumatrassamee, V Phupong, T Snabboon
Abstract
Open AccessBackground: 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 cortical-sparing tumor resection during the second trimester without complications and subsequently delivered a healthy full-term 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.