Paraganglioma in Pregnancy with Recurrent Pregnancy Loss

A Case Report

Authors

DOI:

https://doi.org/10.15605/jafes.040.01.09

Keywords:

paraganglioma, pheochromocytoma, pregnancy, catecholamine

Abstract

Due to its rarity, pheochromocytoma or paraganglioma (PPGL) in pregnancy is often not timely diagnosed, thus resulting in high materno-fetal complications. We report a 28-year-old female who presented with paroxysmal symptoms and severe hypertension during early pregnancy. Biochemical confirmatory tests and localization imaging were delayed due to multiple factors. She suffered from two pregnancy losses before she had resection of the paraganglioma.

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Author Biographies

Wee Mee Cheng, Hospital Putrajaya

Endocrine Unit, Hospital Putrajaya, Putrajaya, Malaysia

Zanariah Hussein, Hospital Putrajaya

Endocrine Unit, Hospital Putrajaya, Putrajaya, Malaysia

References

1. Clifton-Bligh RJ. The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy. Rev Endocr Metab Disord. 2023;24(1):49-56. https://pubmed.ncbi.nlm.nih.gov/36637675 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9884650 DOI: 10.1007/s11154-022-09773-2 DOI: https://doi.org/10.1007/s11154-022-09773-2

2. Langton K, Tufton N, Akker S, et al. Pregnancy and phaeochromocytoma/paraganglioma: Clinical clues affecting diagnosis and outcome – a systematic review. BJOG. 2021;128(8):1264–72. https://pubmed.ncbi.nlm.nih.gov/33342020 DOI: 10.1111/1471-0528.16635 DOI: https://doi.org/10.1111/1471-0528.16635

3. Oliva R, Angelos P, Kaplan E, Bakris G. Pheochromocytoma in pregnancy: A case series and review. Hypertension. 2010;55(3):600-6. https://pubmed.ncbi.nlm.nih.gov/20083723 DOI: 10.1161/HYPERTENSIONAHA.109.147579 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.109.147579

4. Bancos I, Atkinson E, Eng C, Young WF, Neumann H, International Pheochromocytoma and Pregnancy Study Group. Maternal and fetal outcomes in pheochromocytomas and pregnancy: A multi-center retrospective cohort study and systematic review of literature. Lancet Diabetes Endocrinol. 2021;9(1):13–21. https://pubmed.ncbi.nlm.nih.gov/33248478 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758862 DOI: 10.1016/S2213-8587(20)30363-6 DOI: https://doi.org/10.1016/S2213-8587(20)30363-6

5. Schenker JG, Chowers I. Pheochromocytoma and pregnancy. Obstet Gynecol Surv. 1971;26(11):739-47. https://pubmed.ncbi.nlm.nih.gov/5173093 DOI: 10.1097/00006254-197111000-00001 DOI: https://doi.org/10.1097/00006254-197111000-00001

6. Lenders JWM. Pheochromocytoma and pregnancy: A deceptive connection. Eur J Endocrinol. 2012;166(2):143-50. https://pubmed.ncbi.nlm.nih.gov/21890650 DOI: 10.1530/EJE-11-0528 DOI: https://doi.org/10.1530/EJE-11-0528

7. Dahia PL, Hayashida CY, Strunz C, Abelin N, Toledo SP. Low cord blood levels of catecholamine from a newborn of a pheochromocytoma patient. Eur J Endocrinol. 1994;130(3):217-9. https://pubmed.ncbi.nlm.nih.gov/8156092 DOI: 10.1530/eje.0.1300217 DOI: https://doi.org/10.1530/eje.0.1300217

8. Shigeo Iijima. Impact of maternal pheochromocytoma on the fetus and neonate, Gynecol Endocrinol. 2019;35(4):280-6. https://pubmed.ncbi.nlm.nih.gov/30614304 DOI: 10.1080/09513590.2018.1540568 DOI: https://doi.org/10.1080/09513590.2018.1540568

9. Gerber S, Hohlfeld P, Viquerat F, Tolsa JF, Vial Y. Intrauterine growth restriction and absent or reverse end-diastolic blood flow in umbilical artery (Doppler class II or III): A retrospective study of short- and long-term fetal morbidity and mortality. Eur J Obstet Gynecol Reprod Biol. 2006;126(1):20-6. https://pubmed.ncbi.nlm.nih.gov/16139414 DOI: 10.1016/j.ejogrb.2005.07.008 DOI: https://doi.org/10.1016/j.ejogrb.2005.07.008

10. Gruber LM, Young WF Jr, Bancos I. Pheochromocytoma and paraganglioma in pregnancy: A new era. Curr Cardiol Rep. 2021;23(6):60. https://pubmed.ncbi.nlm.nih.gov/33961120 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251512 https://doi.org/10.1007/s11886-021-01485-4 DOI: https://doi.org/10.1007/s11886-021-01485-4

11. Committee Opinion No. 723: Guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol. 2017;130(4):e210-6. https://pubmed.ncbi.nlm.nih.gov/28937575 https://doi.org/10.1097/AOG.0000000000002355. Erratum in: Obstet Gynecol. 2018;132(3):786. https://pubmed.ncbi.nlm.nih.gov/30134410 https://doi.org/10.1097/AOG.0000000000002858 DOI: https://doi.org/10.1097/AOG.0000000000002355

12. Jaiswal SK, Sarathi V, Malhotra G, et al. The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma: Asian Indian experience. Indian J Endocrinol Metab. 2021;25(5):410-7. DOI: https://doi.org/10.4103/ijem.ijem_307_21

13. Maaz AUR, O'Doherty J, Djekidel M. 68Ga-DOTATATE PET/CT for neuroblastoma staging: Utility for clinical use. J Nucl Med Technol. 2021;49(3):265-8. https://pubmed.ncbi.nlm.nih.gov/33820858 https://doi.org/10.2967/jnmt.120.258939 DOI: https://doi.org/10.2967/jnmt.120.258939

14. ACR Practice Guideline for imaging pregnant or potentially pregnant adolescents and women with ionizing radiation. Reston (VA): ACR; 2008. https://cdn.who.int/media/docs/default-source/hq-tuberculosis/global-task-force-on-tb-impact-measurement/meetings/2009-01/7_imaging_pregnant_women_acr.pdf?sfvrsn=59aaa180_5

15. Plouin PF, Amar L, Dekkers OM, et al. Guideline Working Group. European Society of Endocrinology Clinical Practice Guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma. Eur J Endocrinol. 2016;174(5):G1-10. https://pubmed.ncbi.nlm.nih.gov/27048283 https://doi.org/10.1530/EJE-16-0033 DOI: https://doi.org/10.1530/EJE-16-0033

16. Papathomas TG, Oudijk L, Persu A, et al. SDHB/SDHA immunohistochemistry in pheochromocytomas and paragangliomas: A multicenter interobserver variation analysis using virtual microscopy: A Multinational Study of the European Network for the Study of Adrenal Tumors (ENS@T). Mod Pathol. 2015;28(6):807-21. https://pubmed.ncbi.nlm.nih.gov/25720320 https://doi.org/10.1038/modpathol.2015.41 DOI: https://doi.org/10.1038/modpathol.2015.41

17. Parasiliti-Caprino M, Lucatello B, Lopez C, et al. Predictors of recurrence of pheochromocytoma and paraganglioma: A multicenter study in Piedmont, Italy. Hypertens Res. 2020;43(6):500-10. https://pubmed.ncbi.nlm.nih.gov/31586159 https://doi.org/10.1038/s41440-019-0339-y DOI: https://doi.org/10.1038/s41440-019-0339-y

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Published

2025-04-25

How to Cite

Cheng, W. M., & Hussein, Z. (2025). Paraganglioma in Pregnancy with Recurrent Pregnancy Loss: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 40(1), 98–103. https://doi.org/10.15605/jafes.040.01.09

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Case Reports