Pheochromocytoma in pregnancy: a case report and review of management challenges

Introduction. Pheochromocytoma is a rare catecholamine-secreting tumor arising from adrenal medullary chromaffin cells. Its incidence during pregnancy is estimated at 0.002-0.007%, making it a diagnostic and therapeutic chal­lenge. Early recognition and management are im­pe­ra­tive to improve maternal and fetal outcomes. We pre­sent the case of a 36-year-old primigravida diagnosed with pheo­chro­mo­cy­to­ma at 7 weeks of gestation. Case pre­sen­ta­tion. A 36-year-old primigravid woman pre­sen­ted with epi­sodic headaches, palpitations, diaphoresis and labile hy­per­ten­sion at 7 weeks of gestation. Biochemical testing re­vealed significantly elevated plasma metanephrines. MRI confirmed a right adrenal mass consistent with pheo­chro­mo­cy­to­ma. Following medical stabilization with alpha- and beta-blockade, she underwent laparoscopic adrenalectomy at 12 weeks and 5 days of gestation. Conclusions. Pheo­chro­mo­cy­to­ma should be considered in cases of labile or re­sis­tant hypertension in early pregnancy. Prompt diag­no­sis, mul­ti­dis­ci­pli­nary management and timely laparoscopic re­sec­tion are crucial to prevent perinatal morbidity and mor­ta­lity.