Groussard Geoffrey, Esnault Alexandre, Meurdra Quentin, Joubert Michael, Simonet Thérèse, Lee Bion Adrien, Dreyfus Michel
Gynécologie-obstétrique et médecine de la reproduction, CHU de Caen, avenue de la Côte de Nacre, 14000 Caen, France.
Gynécologie-obstétrique et médecine de la reproduction, CHU de Caen, avenue de la Côte de Nacre, 14000 Caen, France.
Gynecol Obstet Fertil Senol. 2025 Jan;53(1):10-15. doi: 10.1016/j.gofs.2024.10.008. Epub 2024 Oct 24.
Carrying out a pregnancy to term in a patient with a paraganglioma or pheochromocytoma (PPGL) results from a multidisciplinary challenge. The objective was to compare our therapeutic attitude with the existing literature and to identify optimal treatment.
Description of a case of paraganglioma treated during pregnancy at the University Hospital Center of Caen (France) in 2024 and comparison with the literature.
We describe a patient with a family history of paraganglioma, in whom paravesical PPGL was discovered at 18 weeks of gestation. The symptoms were marked by episodes of palpitations and headaches during urination. The diagnosis was confirmed by a measurement of urinary metanephrines associated with magnetic resonance imaging. After initiation of alpha-blocker treatment, delivery was performed by cesarean section at 36 weeks of gestation. An excision was carried out by laparoscopy 2 months postpartum without intra- and postoperative complications.
The absence of antenatal diagnosis of PPGL is the main risk factor increasing maternal and fetal mortality. Certain criteria such as a family history, the appearance of early or malignant arterial hypertension should suggest the diagnosis of PPGL. The initiation of alpha-blocker treatment upon diagnosis is essential. The curative therapy remains surgical excision. Its timing depends on its size, location, term of pregnancy and route of delivery. It is preferable to postpone it until postpartum in order to reduce the risk of complications.
对于患有副神经节瘤或嗜铬细胞瘤（PPGL）的患者，将妊娠维持至足月是一项多学科挑战。目的是将我们的治疗态度与现有文献进行比较，并确定最佳治疗方法。
描述2024年在法国卡昂大学医院中心治疗的一例妊娠期间的副神经节瘤病例，并与文献进行比较。
我们描述了一名有副神经节瘤家族史的患者，在妊娠18周时发现膀胱旁PPGL。症状表现为排尿时心悸和头痛发作。通过测量尿甲氧基肾上腺素并结合磁共振成像确诊。在开始使用α受体阻滞剂治疗后，于妊娠36周行剖宫产分娩。产后2个月通过腹腔镜进行切除，无术中及术后并发症。
PPGL产前未诊断是增加母婴死亡率的主要危险因素。某些标准，如家族史、早期或恶性动脉高血压的出现，应提示PPGL的诊断。诊断后开始使用α受体阻滞剂治疗至关重要。根治性治疗仍然是手术切除。其时机取决于肿瘤大小、位置、妊娠孕周和分娩方式。为降低并发症风险，最好推迟至产后进行。
