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Phoon WL, Kanalingam D, Chua HL
Correspondence: Dr Jessie Phoon, jess_phoon@yahoo.com
ABSTRACT
Adrenal gland tumours in pregnancy are very rare occurrences and have highly variable clinical presentations. The timely diagnosis of adrenal tumours in pregnancy is extremely important, as failure to do so may lead to fatality. As there is limited published literature on adrenal tumours in pregnancy and no consensus on its management, the management of such patients with regard to medical and surgical treatments, as well as timing of delivery, must therefore be individualised and carried out with multidisciplinary expertise. We present two cases of adrenal tumours in pregnancy, both with favourable outcomes and variable gestations. Our first and second cases discuss a large phaeochromocytoma and a cortisol-secreting adrenal cortical adenoma in pregnancy, respectively.
Singapore Med J 2013; 54(7): e141–e145; http://dx.doi.org/10.11622/smedj.2013068
REFERENCES
| 1. Hermida RC, Ayala DE, Mojón A, et al. Blood pressure patterns in normal pregnancy, gestational hypertension, and preeclampsia. Hypertension 2000; 36:149-58. http://dx.doi.org/10.1161/01.HYP.36.2.149 |
||||
| 2. Abraham MR, Khardori R, Spandorfer SD, Talavera F. Adrenal disease and pregnancy. In: Endocrinology Articles (Pathophysiology, Symptoms, Causes, Diagnosis, Treatment, Medication, Surgery, Prognosis) – Medscape Reference [online]. Available at: http://emedicine.medscape.com/endocrinology. | ||||
| 3. Oliva R, Angelos P, Kaplan E, Bakris G. Pheochromocytoma in pregnancy: a case series and review. Hypertension 2010; 55:600-6. http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.147579 |
||||
| 4. Lenders JW, Pacak K, Walther MM, et al. Biochemical diagnosis of pheochromocytoma: which test is best? JAMA 2002; 287:1427-34. http://dx.doi.org/10.1001/jama.287.11.1427 |
||||
| 5. Sawka AM, Jaeschke R, Singh RJ, Young WF Jr. A comparison of biochemical tests for pheochromocytoma: measurement of fractionated plasma metanephrines compared with the combination of 24-hour urinary metanephrines and catecholamines. J Clin Endocrinol Metab 2003; 88:553-8. http://dx.doi.org/10.1210/jc.2002-021251 |
||||
| 6. George J, Tan JYL. Pheochromocytoma in pregnancy: a case report and review of literature. Obstet Med 2010; 3:83-5. http://dx.doi.org/10.1258/om.2010.090063 |
||||
| 7. Jaffe RB, Harrison TS, Cerny JC. Localization of metastatic pheochromocytoma in pregnancy by caval catheterization. Including urinary catecholamine values in uncomplicated pregnancies. Am J Obset Gynecol 1969; 104:939-44. | ||||
| 8. Amar L, Servais A, Gimenez-Roqueplo AP, et al. Year of diagnosis, features at presentation, and risk of recurrence in patients with phaeochromocytoma or secreting paraganglioma. J Clin Endocrinol Metab 2005; 90:2110-6. http://dx.doi.org/10.1210/jc.2004-1398 |
||||
| 9. Shapiro B, Gross MD. Endocrine crises. Pheochromocytoma. Crit Care Clin 1991; 7:1-21. | ||||
| 10. Lyman DJ. Paroxysmal hypertension, pheochromocytoma, and pregnancy. J Am Board Fam Pract 2002; 15:153-8. | ||||
| 11. Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. BMJ 1990; 301:587-9. http://dx.doi.org/10.1136/bmj.301.6752.587 |
||||
| 12. Ahlawat SK, Jain S, Kumari S, Varma S, Sharma BK. Pheochromocytoma associated with pregnancy: case report and review of the literature. Obstet Gynecol Surv 1999; 54:728-37. http://dx.doi.org/10.1097/00006254-199911000-00025 |
||||
| 13. Chandraharan E, Arulkumaran S. Pituitary and adrenal disorders complicating pregnancy. Curr Opin Obstet Gynecol 2003; 15:101-6. http://dx.doi.org/10.1097/00001703-200304000-00003 |
||||
| 14. Kuruba R, Gallagher SF. Current management of adrenal tumors. Curr Opin Oncol 2008; 20:34-46. http://dx.doi.org/10.1097/CCO.0b013e3282f301fd |
||||
| 15. Lenders JW, Eisenhofer G, Mannelli M, Pacak K. Phaeochromocytoma. Lancet 2005; 366:665-75. http://dx.doi.org/10.1016/S0140-6736(05)67139-5 |
||||