Postpartum diagnosis of pheochromocytoma presenting as atypical hypertensive disorder of pregnancy: A case report

Introduction Pheochromocytoma, a catecholamine-secreting adrenal tumour, is a rare but important cause of hypertension in pregnancy. Its symptoms may mimic more common disorders of pregnancy, making diagnosis challenging. We present a postpartum pheochromocytoma diagnosis with favourable maternal and neonatal outcomes. Case presentation A 29-year-old woman in her first pregnancy developed proteinuria at 34 weeks and new-onset hypertension at 36 weeks, managed as pre-eclampsia. Worsening hypertension, gestational diabetes and breech presentation led to caesarean section at 36 weeks and 4 days of gestation. Postpartum, she experienced severe headaches, labile blood pressure, tachycardia and sweating. Imaging identified a 4 cm right adrenal mass. Markedly elevated plasma and urinary normetanephrines confirmed pheochromocytoma. Right adrenalectomy was performed seven weeks post-partum, with complete excision. Symptoms resolved postoperatively. Subsequent surveillance imaging showed no recurrence. She later had a second uncomplicated pregnancy. Conclusion This case highlights how pheochromocytoma in pregnancy can be differentiated from more common conditions. Prompt diagnosis and multidisciplinary management can optimise patient outcomes.