Document Detail


Diagnostic and therapeutic dilemmas of hypercortisolemia during pregnancy: a case report.
MedLine Citation:
PMID:  19350859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pregnancy and Cushing's syndrome rarely coexist. When they do, it is generally the result of the presence of an adrenal adenoma. Because of significantly increased morbidity and mortality in both the mother and fetus when hypercortisolism is present, it is imperative that it be treated when recognized. This treatment can take the form of definitive surgical treatment or temporary medical treatment until after delivery, both of which carry risks and benefits. Complicating the evaluation, however, it is well known that pregnancy itself can induce many of the symptoms and laboratory abnormalities associated with hypercortisolism. We present the case of a 35-year-old woman who was noted to have an adrenal mass before pregnancy, but then during evaluation became pregnant. Her case is particularly intriguing because she had only vague clinical symptoms and mild laboratory abnormalities but also had a complicating pituitary mass noted on MRI. We outline the evaluation process and eventual laparoscopic adrenalectomy during the second trimester in this unique and difficult case, and discuss risks and benefits of different treatment options for hypercortisolism during pregnancy.
Authors:
Kyla P Terhune; Shubhada Jagasia; Lewis S Blevins; John E Phay
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  75     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-04-08     Completed Date:  2009-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  232-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2730, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  surgery*
Adrenal Gland Neoplasms / complications,  surgery*
Adrenalectomy / methods*
Adult
Cushing Syndrome / diagnosis,  surgery*
Female
Humans
Laparoscopy
Magnetic Resonance Imaging
Pregnancy
Pregnancy Complications / diagnosis,  surgery*
Pregnancy Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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