Sweeney W J, Katz V L
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill.
Obstet Gynecol. 1994 May;83(5 Pt 2):820-2.
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.
嗜铬细胞瘤常复发。嗜铬细胞瘤的治疗方法是肾上腺切除术，双侧肾上腺切除术后已成功实现妊娠。妊娠期复发性嗜铬细胞瘤对母亲和胎儿均有高风险。
一名初产妇，既往因嗜铬细胞瘤接受双侧肾上腺切除术，孕期密切随访，关注肿瘤复发可能性。孕18周时，产妇心动过速、尿儿茶酚胺升高及血细胞比容水平上升提示嗜铬细胞瘤复发。采取了药物治疗及产前检查。因羊水减少，孕36周时引产，经阴道分娩出一名体重2649克的健康婴儿。产后无母体并发症发生。
复发性嗜铬细胞瘤的体征之一是血液浓缩，其与儿茶酚胺增加相结合，可能导致子宫胎盘功能不全。通过严密监测，可取得良好结局。
