Paraganglioma in Pregnancy: A Case Series and Review of the Literature

J Clin Endocrinol Metab. 2015 Aug;100(8):3202-9. doi: 10.1210/jc.2015-2122. Epub 2015 Jun 17.

Abstract

Context: Pregnancies complicated by a pheochromocytoma or paraganglioma are very rare, being estimated to occur in 0.007% of all pregnancies. Both the well-being of the mother and fetus need to be considered, and management can be challenging. The optimal management of women with a pheochromocytoma or paraganglioma in pregnancy is not well established.

Objective: The objective of the study was to assess whether there is a difference in fetal or maternal mortality between pheochromocytomas and paragangliomas in pregnancy.

Design: We present an experience of eight pregnancies in four SDHB germline mutation-positive women with sympathetic paragangliomas, followed by a systematic review of the literature to compare the outcome of paragangliomas with that of pheochromocytomas occurring in pregnancy.

Results: In our case series, favorable fetal and maternal outcomes were seen in all eight pregnancies. From the systematic review, maternal and fetal mortality were lower in women with paragangliomas, at 3.6% and 12% respectively, compared with 9.8% and 16% in women with pheochromocytomas.

Conclusion: Pregnant women with paragangliomas may be at a lower risk of adverse outcome than those with pheochromocytomas, but both maternal and fetal mortality rates are still higher than that of the general obstetric population.

Publication types

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

MeSH terms

  • Adolescent
  • Adrenal Gland Neoplasms* / diagnosis
  • Adrenal Gland Neoplasms* / epidemiology
  • Adrenal Gland Neoplasms* / genetics
  • Adrenal Gland Neoplasms* / therapy
  • Adult
  • Female
  • Humans
  • Paraganglioma* / diagnosis
  • Paraganglioma* / epidemiology
  • Paraganglioma* / genetics
  • Paraganglioma* / therapy
  • Pedigree
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / epidemiology
  • Pheochromocytoma / genetics
  • Pregnancy
  • Pregnancy Complications, Neoplastic* / diagnosis
  • Pregnancy Complications, Neoplastic* / epidemiology
  • Pregnancy Complications, Neoplastic* / genetics
  • Pregnancy Complications, Neoplastic* / therapy
  • Pregnancy Outcome* / epidemiology
  • Siblings
  • Young Adult