Hypertensive crisis during spinal anesthesia due to undiagnosed pheochromocytoma

Undiagnosed pheochromocytoma poses significant intraoperative challenges to the anesthesiologist. These tumors generally cause profound hypotension after spinal anesthesia. We present an unusual case of a hypertensive crisis occurring in a patient under spinal anesthesia. Due to intraoperative hemodynamic instability, the case was converted to general anesthesia with a volatile anesthetic. Postoperative workup was consistent with a pheochromocytoma. Pheochromocytomas are rare, but given their significant intraoperative morbidity and mortality, they should be considered in the differential diagnosis of unexpected intraoperative hemodynamic changes.