|Table of Contents|

Clinical characteristics and prognostic analysis of pregnancy complicated with pheochromocytoma and paraganglioma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 16
Page:
3066-3071
Research Field:
Publishing date:

Info

Title:
Clinical characteristics and prognostic analysis of pregnancy complicated with pheochromocytoma and paraganglioma
Author(s):
LI YunGAO HongboLI LongminCHEN KailinLIU HaichunZHANG XiaoyongSHAO Yujun
Radionuclide Treatment Center,Beijing Nuclear Industry Hospital,Beijing 102413,China.
Keywords:
pregnancypheochromocytomaparagangliomaprognosis
PACS:
R736
DOI:
10.3969/j.issn.1672-4992.2024.16.020
Abstract:
Objective:To investigate the clinical characteristics of pregnancy complicated with pheochromocytoma and paraganglioma (PPGL) and their impact on prognosis.Methods:The clinical data of 16 pregnant patients with PPGL and 32 age-matched non-pregnant patients with PPGL treated in our hospital from January 2014 to January 2023 were retrospectively analyzed,and the clinical characteristics and progression-free survival (PFS) of the two groups were compared.Results:There were statistically significant differences between pregnancy with PPGL group and non-pregnancy with PPGL group in the incidence of hypertension,the expression of 24-hour urine adrenaline (E),24-hour urine norepinephrine (NE),gene mutation,and the number of recurrence and metastasis (P<0.05).Pregnancy with PPGL had shorter PFS than non-pregnancy with PPGL (χ2=28.107,P<0.01).Multivariate analysis showed that PPGL combined with pregnancy,gene mutation and mutated gene SDHB were independent prognostic factors for PFS in PPGL patients (P<0.05).Conclusion:The recurrence and metastasis of pregnancy with PPGL occurred not only in large number but also in early time.Pregnancy is an important factor affecting the recurrence and metastasis of PPGL,which affects the prognosis of patients.

References:

[1] LENDER JW,DUH QY,EISENHOFER G,et al.Pheochromocytoma and paraganglioma:an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2014,99(6):1915-1942.
[2] NEUMANN HPH,YOUNG WF,ENG C.Pheochromocytoma and paraganglioma[J].N Engl J Med,2019,381(6):552-565.
[3] LENDERS JWM,KERSTENS MN,AMAR L,et al.Genetics,diagnosis,management and future directions of research of phaeochromocytoma and paraganglioma:a position statement and consensus of the working group on endocrine hypertension of the european society of hypertension[J].J Hypertens,2020,38(8):1443-1456.
[4] QUARTERMAINE G,LAMBERT K,REES K,et al.Hormone-secreting adrenal tumours cause severe hypertension and high rates of poor pregnancy outcome;a UK obstetric surveillance system study with case control comparisons[J].BJOG,2018,125(6):719-727.
[5] AYGUN N,ULUDAG M.Pheochromocytoma and paraganglioma:from clinical findings to diagnosis[J].Sisli Etfal Hastan Tip Bul,2020,54(3):271-280.
[6] VAN DER WEERD K,VAN NOORD C,LOEVE M,et al.Endocrinology in pregnancy:pheochromocytoma in pregnancy:case series and review of literature[J].Eur J Endocrinol,2017,177(2):R49-R58.
[7] DONATINI G,KRAIMPS JL,CAILLARD C,et al.Pheochromocytoma diagnosed during pregnancy:lessons learned from a series of ten patients[J].Surg Endosc,2018,32(9):3890-3900.
[8] SALAZAR-VEGA JL,LEVIN G,SANSO G,et al.Pheochromocytoma associated with pregnancy:unexpected favourable outcome in patients diagnosed after delivery[J].J Hypertens,2014,32(7):1458-1463,discussion 1463.
[9] DONG D,LI H.Diagnosis and treatment of pheochromocytoma during pregnancy[J].J Matern Fetal Neonatal Med,2014,27(18):1930-1934.
[10] PHOON JW,KANALINGAM D,CHUA HL.Adrenal tumours in pregnancy:diagnostic challenge and management dilemma[J].Singapore Med J,2013,54(7):e141-145.
[11] 徐维锋,李汉忠,严维刚,等.妊娠合并嗜铬细胞瘤的诊断与处理[J].中华泌尿外科杂志,2011,32(4):254-257. XU WF,LI HZ,YAN WG,et al.Diagnosis and management of pheochromocytoma in pregnancy[J].Chin J Urol,2011,32(4):254-257.
[12] BANCOS I,ATKINSON E,ENG C,et al.Maternal and fetal outcomes in phaeochromocytoma and pregnancy:a multicentre retrospective cohort study and systematic review of literature[J].Lancet Diabetes Endocrinol,2021,9(1):13-21.
[13] CLIFTON-BLIGH RJ.The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy[J].Rev Endocr Metab Disord,2023,24(1):49-56.
[14] 中华医学会内分泌学分会.嗜铬细胞瘤和副神经节瘤诊断治疗专家共识(2020版)[J].中华内分泌代谢杂志,2020,36(9):737-750. ENDOCRINOLOGY CSO.Expert consensus on the diagnosis and treatment of pheochromocytoma and paraganglioma (2020)[J].Chin J Endocrinol Metab,2020,36(9):737-750.
[15] PATEL D,PHAY JE,YEN TWF,et al.Update on pheochromocytoma and paraganglioma from the SSO endocrine/head and neck disease-site work group.part 1 of 2:advances in pathogenesis and diagnosis of pheochromocytoma and paraganglioma[J].Ann Surg Oncol,2020,27(5):1329-1337.
[16] FALHAMMAR H,KJELLMAN M,CALISSENDORFF J.Initial clinical presentation and spectrum of pheochromocytoma:a study of 94 cases from a single center[J].Endocr Connect,2018,7(1):186-192.
[17] EBBEHOJ A,STOCHHOLM K,JACOBSEN SF,et al.Incidence and clinical presentation of pheochromocytoma and sympathetic paraganglioma:a population-based study[J].J Clin Endocrinol Metab,2021,106(5):e2251-e2261.
[18] GRUBER LM,YOUNG WF,BANCOS I.Pheochromocytoma and paraganglioma in pregnancy:a new era[J].Curr Cardiol Rep,2021,23(6):60.
[19] GRUBER LM,HARTMAN RP,THOMPSON GB,et al.Pheochromocytoma characteristics and behavior differ depending on method of discovery[J].J Clin Endocrinol Metab,2019,104(5):1386-1393.
[20] VAN BERKEL A,LENDERS JW,TIMMERS HJ.Diagnosis of endocrine disease:biochemical diagnosis of phaeochromocytoma and paraganglioma[J].Eur J Endocrinol,2014,170(3):R109-119.
[21] CASTRO-VEGA LJ,LETOUZE E,BURNICHON N,et al.Multi-omics analysis defines core genomic alterations in pheochromocytomas and paragangliomas[J].Nat Commun,2015,6:6044.
[22] JOCHMANOVA I,PACAK K.Genomic landscape of pheochromocytoma and paraganglioma[J].Trends Cancer,2018,4(1):6-9.
[23] GARCIA-CARBONERO R,MATUTE TERESA F,MERCADER-CIDONCHA E,et al.Multidisciplinary practice guidelines for the diagnosis,genetic counseling and treatment of pheochromocytomas and paragangliomas[J].Clin Transl Oncol,2021,23(10):1995-2019.
[24] PLOUIN PF,AMAR L,DEKKERS OM,et al.European society of endocrinology clinical practice guideline for long-term follow-up of patients operated on for a phaeochromocytoma or a paraganglioma[J].Eur J Endocrinol,2016,174(5):G1-G10.
[25] AMAR L,FASSNACHT M,GIMENEZ-ROQUEPLO AP,et al.Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma[J].Horm Metab Res,2012,44(5):385-389.

[26] FAVIER J,AMAR L,GIMENEZ-ROQUEPLO AP.Paraganglioma and phaeochromocytoma:from genetics to personalized medicine[J].Nat Rev Endocrinol,2015,11(2):101-111.
[27] NICOLAS M,DAHIA P.Predictors of outcome in phaeochromocytomas and paragangliomas[J].F1000Res,2017,6:2160.
[28] KORAKITI AM,MOUTAFI M,ZOGRAFOS E,et al.The genomic profile of pregnancy-associated breast cancer:a systematic review[J].Front Oncol,2020,10:1773.
[29] 中华医学会外科学分会乳腺外科学组.妊娠相关性乳腺癌临床诊治专家共识(2020版)[J].中华临床医师杂志(电子版),2020,14(5):321-325. BREAST SURGERY CSO.Expert consensus on clinical treatment of pregnancy-associated breast cancer (2020 Edition) [J].Chin J Clinicians(Electronic Edition),2020,14(5):321-325.
[30] 石玉香,李莉,谢永辉,等.妊娠相关性乳腺癌临床病理特点及预后[J].实用医学杂志,2021,37(5):632-636. SHI YX,LI L,XIE YH,et al.Pathological features and prognosis of pregnancy-associated breast cancer[J].The Journal of Practical Medicine,2021,37(5):632-636.
[31] LOPEZ AG,DUPARC C,RENOUF S,et al.Expression of LHCGR in pheochromocytomas unveils an endocrine mechanism connecting pregnancy and epinephrine overproduction[J].Hypertension,2022,79(5):1006-1016.

Memo

Memo:
中国宝原科研基金项目(编号:ZGBYKY-2021-002)
Last Update: 1900-01-01