Pheochromocytoma in a pregnant patient.

Pheochromocytoma accounts for only 0.1% of hypertension found in adults between 40 and 70 years of age. Although it is extremely rare in pregnancy, if it occurs and is unrecognized in pregnant women, pheochromocytoma can have catastrophic effects. For instance, maternal fatal hypertension can be precipitated by anesthesia, vaginal delivery, uterine contractions, or even vigorous fetal movements. Fetal growth retardation is often seen secondary to decreases in uteroplacental perfusion. Fetal hypoxia or death can also occur with maternal episodes of headache, palpitations, and diaphoresis related to tumor secretions. Because many of the signs and symptoms of pheochromocytoma are similar to more frequently encountered hypertensive syndromes related to pregnancy, the diagnosis of pheochromocytoma can be easily overlooked. The case report presented here illustrates the difficulties associated with the diagnosis of pheochromocytoma in a pregnant patient, highlights problems encountered by patients with the tumor, and reviews diagnostic and treatment approaches.