Phaeochromocytoma presenting as acute malignant hyperthermia--a diagnostic challenge

We report a case of acute hypermetabolism following the induction of general anaesthesia in an 11-yr-old boy. This episode was diagnosed and managed as an acute malignant hyperthermia crisis. However, severe hypertension during the episode led to the discovery of an unsuspected phaeochromocytoma. A hypermetabolic state during anaesthesia has several aetiologies, but correct diagnosis during the acute episode may be difficult.