Adrenal cortical carcinoma mimicking early severe preeclampsia

Preeclampsia is a common disorder in pregnancy and may affect multiple maternal and foetal organ systems. Less common disorders with similar features may imitate preeclampsia though require different management strategies and with different prognostic implications for mother and baby. We present a case of a pregnant woman who developed severe hypertension and proteinuria in pregnancy. The early onset of these changes prompted investigation for causes other than preeclampsia, leading to a diagnosis of Cushing's syndrome due to stage III adrenocortical cancer. The changes in management strategy, the importance of a multidisciplinary approach to care, and the prognostic implications for the mother are discussed.