Pheochromocytoma in pregnancy often missed.(Clinical Rounds)

BETHESDA, MD. -- With timely diagnosis and treatment, the prognosis can be good for women with pheochromocytoma during pregnancy, Dr. Henri Timmers said at an international symposium on pheochromocytoma sponsored by the National Institutes of Health.

In his conclusion, based on a literature review of more than 100 cases, he also found that maternal morbidity is high when diagnosis is delayed, said Dr. Timmers of the department of endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.

Pheochromocytoma affects an estimated 1/50,000 full-term pregnancies and is associated with high maternal and fetal morbidity and mortality. Pheochromocytoma during pregnancy is often missed because it can mimic preeclampsia, delaying diagnosis and appropriate treatment, he noted.

Dr. Timmers and his associates found a total of 174 reports of histology-confirmed cases of pheochromocytoma during pregnancy, in a PubMed database search for case reports in English. The mean age of the women was 28 years, 7% had previously been diagnosed with pheochromocytoma and 17% had been previously diagnosed with hypertension; 61% had been pregnant before and 14% had been previously diagnosed with pregnancy-induced hypertension.

In 73% of cases, the diagnosis of pheochromocytoma was made before delivery, with the remainder diagnosed postpartum (17%) or postmortem (10%).

Nearly 90% of the patients were hypertensive, but in only 42% of the cases was presentation typical for ...