Extra-adrenal paraganglioma masquerading as severe preeclampsia

• Published in: Obstetrics & gynecology science Vol. 61; no. 4; pp. 520 - 523
• Main Authors: Kim, Hyeon Ji, Yang, Shin Ho, Yang, Sun Hye, Han, Seung Su, Kim, Gwang Jun
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 01.07.2018; Korean Society of Obstetrics and Gynecology; 대한산부인과학회
• Subjects: Case Report; hypertension; paraganglioma; preeclampsia; pregnancy; 산부인과학; Hypertension; Pregnancy; Paraganglioma; Preeclampsia
• ISSN: 2287-8572; 2287-8580
• DOI: 10.5468/ogs.2018.61.4.520

Paraganglioma in pregnancy is an extremely rare condition and its diagnosis is often delayed because the clinical symptoms can mimic those of preeclampsia or gestational hypertension. Here, we report the case of a 32-year-old, gravida 2, para 1 woman who presented with severe headache, palpitation, and sweating at 37 weeks' gestation. Although emergent cesarean section was performed on the assumption of severe preeclampsia, blood pressure fluctuated and heart rate remained tachycardiac. We suspected that she might have thromboembolic lesion in the chest or pheochromocytoma. Chest and abdominal computed tomography revealed a 4 cm mass in the left para-aortic space. Serum and urinary catecholamine levels were found to be significantly increased. She underwent laparoscopic mass removal and the pathology confirmed paraganglioma. When typical paroxysmal hypertension is accompanied by headache, palpitation, and sweating during pregnancy, adrenal tumors should be considered.