The diagnosis and treatment of adrenocortical carcinoma in pregnancy: a case report

Abstract Background Pregnancy complicated with adrenocortical carcinoma (ACC) is a sporadic syndrome that is characterized by hypertension, uncontrolled hypokalemia, severe heart failure, premature delivery and other adverse effects. The clinical presentation of adrenocortical carcinoma is vague and...

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Main Authors: Yuanli Zhang (Author), Zeng Yuan (Author), Chunping Qiu (Author), Shuyi Li (Author), Shiqian Zhang (Author), Yan Fang (Author)
Format: Book
Published: BMC, 2020-01-01T00:00:00Z.
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LEADER 00000 am a22000003u 4500
001 doaj_accd8daebb534e6b96a990ca7e6f09a0
042 |a dc 
100 1 0 |a Yuanli Zhang  |e author 
700 1 0 |a Zeng Yuan  |e author 
700 1 0 |a Chunping Qiu  |e author 
700 1 0 |a Shuyi Li  |e author 
700 1 0 |a Shiqian Zhang  |e author 
700 1 0 |a Yan Fang  |e author 
245 0 0 |a The diagnosis and treatment of adrenocortical carcinoma in pregnancy: a case report 
260 |b BMC,   |c 2020-01-01T00:00:00Z. 
500 |a 10.1186/s12884-020-2737-1 
500 |a 1471-2393 
520 |a Abstract Background Pregnancy complicated with adrenocortical carcinoma (ACC) is a sporadic syndrome that is characterized by hypertension, uncontrolled hypokalemia, severe heart failure, premature delivery and other adverse effects. The clinical presentation of adrenocortical carcinoma is vague and nonspecific, it is challenging to identify complications of pregnancy with adrenocortical carcinoma. Here we present a case of adrenocortical carcinoma during pregnancy. We describe how to distinguish secondary hypertension from other conditions and the importance of timely detection and treatment of such patients. Case presentation A 22-year-old woman 30 weeks pregnant was hospitalized with uncontrolled hypertension and hypokalemia. An ultrasound examination of the right adrenal gland revealed a large mass. She underwent transabdominal adrenalectomy, and histopathology from the sample removed revealed an adrenocortical carcinoma. Five days after surgery, the patient had a premature rupture of the fetal membranes and gave birth to a newborn girl via vaginal delivery at 32 weeks of gestation. The newborn was transferred to the neonatal pediatrics ward, and the woman started receiving chemotherapy. Conclusions Pregnancy with adrenocortical carcinoma is a rare condition. This case alerts the obstetricians that analysis of hypertension, hypokalemia, the plasma level and circadian rhythm of plasma cortisol provides a strategy to diagnose adrenocortical carcinoma during pregnancy. 
546 |a EN 
690 |a Pregnancy 
690 |a Adrenocortical carcinoma 
690 |a Differential diagnosis 
690 |a Case report 
690 |a Gynecology and obstetrics 
690 |a RG1-991 
655 7 |a article  |2 local 
786 0 |n BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-5 (2020) 
787 0 |n https://doi.org/10.1186/s12884-020-2737-1 
787 0 |n https://doaj.org/toc/1471-2393 
856 4 1 |u https://doaj.org/article/accd8daebb534e6b96a990ca7e6f09a0  |z Connect to this object online.