RECURRENT PHEOCHROMOCYTOMA DURING PREGNANCY

Background: Pheochromocytoma recurs commonly. The treatment for pheoch romocytoma is adrenalectomy, and successful pregnancy has been achieve d after bilateral adrenalectomy. Recurrent pheochromocytoma in pregnan cy carries a high risk for mother and fetus. Case: A primigravid woman with prior bilateral adrenalectomy for pheochromocytoma was followed during her pregnancy with careful attention to the possibility of tumo r recurrence. Maternal tachycardia, elevated urinary catecholamines, a nd rising hematocrit levels indicated recurrence of the pheochromocyto ma at 18 weeks' gestation. Medical therapy and antenatal testing were instituted. Labor was induced at 36 weeks' gestation because of decrea sing amniotic fluid volume, and a healthy 2649-g infant was delivered vaginally. No maternal complications occurred in the postpartum period . Conclusion: One of the signs of recurrent pheochromocytoma is hemoco ncentration which, in combination with increased catecholamines, may l ead to uteroplacental insufficiency. With intense surveillance, good o utcomes may be achieved.