Recurrent pheochromocytoma during pregnancy

Pheochromocytoma recurs commonly. The treatment for pheochromocytoma is adrenalectomy, and successful pregnancy has been achieved after bilateral adrenalectomy. Recurrent pheochromocytoma in pregnancy carries a high risk for mother and fetus.

A primigravid woman with prior bilateral adrenalectomy for pheochromocytoma was followed during her pregnancy with careful attention to the possibility of tumor recurrence. Maternal tachycardia, elevated urinary catecholamines, and rising hematocrit levels indicated recurrence of the pheochromocytoma at 18 weeks' gestation. Medical therapy and antenatal testing were instituted. Labor was induced at 36 weeks' gestation because of decreasing amniotic fluid volume, and a healthy 2649-g infant was delivered vaginally. No maternal complications occurred in the postpartum period.

One of the signs of recurrent pheochromocytoma is hemoconcentration which, in combination with increased catecholamines, may lead to uteroplacental insufficiency. With intense surveillance, good outcomes may be achieved.