Elif Sevil ALAGÜNEY, Fatma Belgin EFE, Funda CANAZ, BARTU BADAK

Gebelikte Feokromositoma

Feokromositoma, katekolamin salgılayan bir nöro-endokrin tümördür. Hamilelikte nadir görülür. Yanlışlıklar gestasyonel hipertansiyon veya preeklampsi tanısı konulması feokromositoma tanısında gecikmelere neden olabilir. Bu çalışmada, gebelikte hipertansiyon ile başvuran ve feokromositoma tanısı konulan bir olguyu tartışmayı amaçladık. Sol yan ağrısı şikayeti olan 27 yaşında onbeş haftalık gebe hastada sol adrenal bezde 45x55 milimetre kitle tespit edilmiştir. Fizik muayenede hipertansiyon saptanan hastanın 24 saatlik idrar katekolamin düzeyleri yüksek tespit edildi. Abdominal MR feokromositoma ile uyumlu saptandı. Preoperatif hazırlığın ardından ikinci trimesterde sol adrenal beze laparoskopik adrenalektomi uygulandı. Ameliyattan sonra katekolamin düzeyleri düştü. Patoloji feokromositoma ile uyumluydu. 37. gebelik haftasında bebek sezaryen ile doğdu. Hamilelik sırasında feokromositoma nadirdir fakat anne ve fetus için önemli bir morbidite ve mortalite nedenidir. Bu nedenle, özellikle ilk trimesterde hipertansiyon ile başvuran gebelerde ayırıcı tanıda düşünülmelidir.

Anahtar Kelimeler:

gebelik, hipertansiyon, feokromositoma, katekolamin

Pheochromocytoma In Pregnancy

Pheochromocytoma is a neuro-endocrine tumor which secretes catecholamine. It is rare in pregnancy. Misdiagnosis as gestational hypertension or preeclampsia may cause delays in diagnosis. We aimed to discuss a case of pheochromocytoma during pregnancy presenting with hypertension. A 27-year-old female patient with 15-weeks of pregnancy was found to have a 45x55 millimeter mass on the left adrenal gland while she was complaining left side pain. Physical examination revealed hypertension. 24-hour urine catecholamine levels were elevated. Abdominal MRI was consistent with pheochromocytoma. After appropriate preparation, laparoscopic adrenalectomy was performed for the left adrenal gland in second trimester. Catecholamine levels decreased after the operation. The pathology was consistent with pheochromocytoma. The patient delivered a baby by cesarean section at 37th gestational week. Pheochromocytoma during pregnancy is a rare but important cause of morbidity and mortality for mother and fetus. Therefore, it should be considered in the differential diagnosis especially in pregnant women presenting with hypertension in first trimester.

Keywords:

pregnancy, hypertension, pheochromocytoma,

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