Bilateral pheochromocytoma during the postpartum period

Arch Gynecol Obstet. 2009 Dec;280(6):1055-8. doi: 10.1007/s00404-009-1057-5. Epub 2009 Apr 2.

Abstract

Background: Pheochromocytoma manifesting during pregnancy is uncommon but it is responsible for a high maternal and fetal mortality rate, especially when unrecognized. Most cases of pheochromocytoma are sporadic but they can be part of hereditary autosomal dominant syndromes.

Case: We describe a case of bilateral pheochromocytoma in a term-pregnant patient with a previous history of medullary thyroid carcinoma (MTC). Her genetic study revealed a heterozygous mutation, c.1900T>C, in the RET proto-oncogene which confirmed the diagnosis of multiple endocrine neoplasia type 2A (MEN2A). Unrecognized, the tumors caused a crisis with fatal outcome in the mother during the postpartum period. This event might have been prevented if the tumor had been detected previously.

Conclusion: MEN2A affected pregnancy is an unusual condition. This syndrome should be suspected when a pregnant patient has a history of MTC. Early detection and appropriate management can prevent serious maternal and fetal complications. We also reviewed the literature of MEN2A-affected pregnancies.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Gland Neoplasms / genetics
  • Adrenal Gland Neoplasms / pathology*
  • Adult
  • DNA, Neoplasm / chemistry
  • DNA, Neoplasm / genetics
  • Fatal Outcome
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Multiple Endocrine Neoplasia Type 2a / genetics
  • Multiple Endocrine Neoplasia Type 2a / pathology*
  • Pheochromocytoma / genetics
  • Pheochromocytoma / pathology*
  • Point Mutation
  • Polymerase Chain Reaction
  • Postpartum Period
  • Pregnancy
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-ret / genetics

Substances

  • DNA, Neoplasm
  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-ret