Management of pheochromocytoma during pregnancy. A multidisciplinary challenge: A case reports

• Published in: International journal of surgery case reports 2023-07, Vol.108, p.108483, Article 108483
• Main Authors: Sghaier, Asma, Reguez, Talel, Moussa, Ameni, Ghali, Amine E.L., Hamila, Fehmi, Youssef, Sabri
• Format: Article
• Language: English
• Subjects: Case Report; Laparoscopy; Perinatality; Pheochromocytoma; Pregnancy
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.108483

Identification of pheochromocytoma during pregnancy is unusual. Lack of appropriate management may be responsible of high risk for both mother and fetus. The guarantee of a successful management of a pheochromocytoma during pregnancy is the establishment of an early diagnosis as well as the prevention of a hypertensive crisis during delivery and surgical treatment and without compromising the maternal-fetal prognosis. A 31-year-old female patient, without any notable pathological history, pregnant at 20 weeks of amenorrhea was diagnosed for a Menard's triad. The medical investigations had allowed to confirm the diagnosis of left secretory pheochromocytoma. The surgical indication was taken in concertation between surgeons, endocrinologists, gynecologists and anesthesiologists. The parturient had undergone an uneventful laparoscopic left adrenalectomy without incidents. Our case well illustrates that when the operative indication is posed, laparoscopic surgery can be performed safely during any trimester. However, it is legitimate to modulate the incisions according to gestational age and the height of the fundus. The involvement of all disciplines intervening in the management of the pregnant woman with pheochromocytoma is the guarantor of a favorable maternal-fetal prognosis. A well-established diagnosis for pregnant women with severe secondary hypertension, multidisciplinary management, and safe laparoscopic approach are crucial to prevent perinatal morbidity and mortality. •Identification of pheochromocytoma during pregnancy is unusual.•This disorder could be responsible of high risk for both mother and fetus.•Diagnosis is carried out on the basis of a series of clinical, biological and morphological investigations.•Management is carried out in consultation with the entire medical staff.