Bembo Shirley A, Elimian Andrew, Waltzer Wayne, Carlson Harold E
Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Stony Brook University, Stony Brook, New York 11794-8154, USA.
Am J Med Sci. 2005 Jun;329(6):317-9. doi: 10.1097/00000441-200506000-00012.
Pheochromocytoma in pregnancy is rare; if unrecognized, potentially fatal hypertensive crises may occur. We report a case of a 35-year-old woman with a history of two intracerebral aneurysms who presented at 26 weeks' gestation with tachycardia, hypertension, and pulmonary edema. Laboratory data revealed elevated 24-hour urinary catecholamine and metanephrine levels, and abdominal sonography showed a 10-cm right adrenal mass. After stabilization with phenoxybenzamine and metoprolol, cesarean section was successfully performed at 36 weeks' gestation. Postpartum abdominal computed tomography scanning confirmed a 10-cm right adrenal mass. A benign pheochromocytoma was removed without incident. This case illustrates the importance of early diagnosis and management of pheochromocytoma in pregnancy and is also an example of the rare association of pheochromocytoma with intracerebral aneurysms.
妊娠期嗜铬细胞瘤较为罕见；若未被识别，可能会发生潜在致命的高血压危象。我们报告一例35岁女性病例，该女性有两次脑动脉瘤病史，妊娠26周时出现心动过速、高血压和肺水肿。实验室检查数据显示24小时尿儿茶酚胺和甲氧基肾上腺素水平升高，腹部超声检查显示右侧肾上腺有一个10厘米大小的肿块。在用酚苄明和美托洛尔稳定病情后，于妊娠36周成功进行了剖宫产。产后腹部计算机断层扫描证实右侧肾上腺有一个10厘米大小的肿块。顺利切除了一个良性嗜铬细胞瘤。该病例说明了妊娠期嗜铬细胞瘤早期诊断和治疗的重要性，也是嗜铬细胞瘤与脑动脉瘤罕见关联的一个例子。
