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Updated: Aug 11, 2026
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Pseudopheochromocytoma of pregnancy
Baiju R Shah1, Shital Gandhi, Sylvia L Asa
1Department of Medicine, University of Toronto, Ontario, Canada.
Objective:
To report a diagnostically challenging case of preeclampsia.
Methods:
We present a case report with clinical, biochemical, imaging, and immunohistochemical findings. In addition, the clinical features of pheochromocytoma during pregnancy are reviewed, and the challenges in distinguishing it from preeclampsia are discussed.
Results:
A 33-year-old woman presented at 14 weeks' gestational age with severe hypertension. Evaluation for secondary causes of hypertension were prompted by difficulty controlling the blood pressure and associated symptoms of headache and nausea. Investigations revealed high levels of urinary catecholamines, in conjunction with increased uptake of (111)In-labeled octreotide in the midabdominal area. At 28 weeks' gestation, worsening of blood pressure, high liver enzyme levels, and proteinuria necessitated a cesarean delivery and concomitant hysterectomy. Blood pressure and urinary catecholamine excretion promptly normalized after delivery. Pathologic examination of the uterus and placenta demonstrated no expression of neuroendocrine markers including chromogranin, but the trophoblast demonstrated strong immunostaining for tyrosine hydroxylase. Expression of this rate-limiting enzyme responsible for catecholamine synthesis may have contributed to the pathogenesis of preeclampsia in this patient.
Conclusion:
This case demonstrates that severe pre-eclampsia may mimic pheochromocytoma.
