ABSTRACT
The diagnosis of pheochromocytoma during pregnancy has rarely been made correctly prior to delivery, only 42 cases having been reported. Antepartum diagnosis markedly decreases the maternal and fetal mortality. We report a case of pheochromocytoma manifesting during the third trimester of pregnancy. Preoperative control of blood pressure with phenoxybenzamine and phentolamine therapy was carried out. Simultaneous cesarean section and excision of the tumor resulted in a healthy mother and newborn infant. We review the perioperative and intraoperative management of patients with a pheochromocytoma during pregnancy.
Subject(s)
Adrenal Gland Neoplasms/surgery , Pheochromocytoma/surgery , Pregnancy Complications/surgery , Adrenal Gland Neoplasms/diagnosis , Adult , Cesarean Section , Female , Humans , Infant, Newborn , Pheochromocytoma/diagnosis , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Trimester, ThirdABSTRACT
The specificity of gonadotropin binding was studied in fresh and frozen human corpora lutea. Ovine, bovine, and porcine luteinizing hormone (LH) competed with 125I-labeled human LH (125I-hLH) and 125I-labeled human chorionic gonadotropin (125I-hCG) for binding to tissue receptors in homogenates of human corpora lutea frozen for 3 to 12 months. In contrast, oLH, bLH, and pLH competed minimally for 125I-hLH and 125I-hCG binding sites in homogenates of fresh human corpora lutea. Ovine follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) did not compete in homogenates of fresh or frozen tissue. Competition of oLH and hCG for 125I-hCG binding sites at several dose levels in a homogenate of a fresh corpus luteum was studied. One hundred micrograms of oLH and ten nanograms of hCG gave an equivalent competition--a 10,000-fold difference in competitive potency. Only hCG competed with 125I-hCG for binding when the competition of oLH, bLH, pLH, oFSH, oTSH, hCG and hCG subunits, and hCG were compared at the 10-mug level in a homogenate of fresh human corpus luteum. The binding of 125I-labeled homologous human hormones by the corpus luteum was examined in a limited fashion. 125I-Prolactin did not bind to preparations of fresh stroma from a patient with polycystic ovaries nor did it bind to three separate preparations of fresh corpora luteum which did bind 125I-hCG. 125I-hTSH did not show significant binding to a fresh human corpus luteum preparation which did bind 125I-hCG. These studies indicate that the gonadotropin receptor of the fresh human corpus luteum possesses a unique species specificity and illustrate the importance of working with human corpora lutea in their most native state.
