Anesthetic management of a patient undergoing surgery for bilateral pheochromocytoma: a case report

Pheochromocytomas are rare neuroendocrine tumors. Patients with pheochromocytoma may develop potentially lethal cardiovascular and other complications, especially in the setting of diagnostic or interventional procedures (e.g. upon induction of anesthesia or during surgery). Perioperative management of patients with pheochromocytoma requires detailed knowledge on the pathophysiology and potential complications. This is a case of a 38 year-old, male, with history of bilateral pheochromocyto-, ma, and hypertension secondary to pheochromocytoma, that was scheduled for open bilateral cortical-sparing adrenalectomy under general anesthesia combined with thoracic epidural anesthesia. Although resection of bilateral pheochromocytomas continues being a challenging situation for the anesthetic management, morbidity and mortality can be significantly decreased with preoperative alpha-antagonists treatment, as well as volume restoration, vasoactive drugs, and closely monitoring intra- and postoperatively.