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DGYE-2010-0119.R1 [507284] 4 pag

Krysiak, Robert; Kobielusz-Gembala, Iwona; Okopien, Boguslaw

Abstract: Pregnancy and lactation are associated with remarkable changes in calcium homeostasis, resulting from pregnancy-induced alterations in the production, metabolism and excretion of calcium and calcitropic hormones. Therefore, the clinical course of disorders affecting the parathyroid glands during pregnancy and lactation is often atypical. As the symptoms experienced by patients with parathyroid disorders are not specific, their diagnosis during gestation and breastfeeding may be sometimes very difficult. If left untreated, parathyroid disorders may pose a significant risk to the mother and fetus associated with increased perinatal and maternal morbidity and mortality. Hypoparathyroidism is a disorder rarely observed during pregnancy, resulting in most cases from surgical thyroidectomy. In our article, we present the case of a 32-year-old female with primary hypoparathyroidism diagnosed for the first time during pregnancy. We describe in details treatment strategies undertaken in this patient and their impact on the outcome of pregnancy and lactation.

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Pheochromocytoma and medullary thyroid carcinoma in a pregnant MEN-2A patient

DGYE-2010-0124.R1 [507285] 3 pag

Sarathi, Vijaya; Bandgar, Tushar; Menon, Padma; Shah, Nalini

Abstract: Objective: We describe a rare combination of pheochromocytoma and medullary thyroid carcinoma (MTC) during pregnancy.
Methods: Twenty three years old lady, primigravida, was detected to be hypertensive at 12 weeks of gestation and was found to have left adrenal mass on routine obstetric scan. She had a goiter on examination which was proved to be medullary thyroid carcinoma on fine needle aspiration cytology. Her 24-h urinary Vannilyl mandelic acid and serum calcitonin levels were elevated. After adequate alpha and beta blockade she underwent left adrenalectomy during second trimester of gestation with no significant perioperative complications. Twelve days later she underwent total thyroidectomy.
Results: Adrenal mass was confirmed to be pheochromocytoma while MTC was confirmed in the thyroidectomy specimen. Postoperatively she was normotensive and delivered a healthy female baby at term. Both mother and the baby tested positive for germ line RET mutation (C634W) in exon 11.
Conclusion: We describe a rare case of pregnant MEN-2A patient with

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Background: Pregnancy associated Krukenberg tumor is very rare, and the diagnosis in pregnancy is even more difficult.  Usually symptoms are attributed to pregnancy luteomas which are hormone active benign neoplasm. more

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