[Anesthetic hazards in an undiagnosed case of retroperitoneal paraganglioma].

Abstract

We report a patient with undiagnosed retroperitoneal paraganglioma who developed an intraoperative hypertensive crisis. A 64-year-old female was scheduled for right partial mastectomy and removal of an abdominal mass, preoperatively diagnosed as a small intestine GIST. Surgery was performed under general anesthesia combined with epidural anesthesia with close monitoring. Immediately after the surgical manipulation of the abdominal mass, her systolic blood pressure rose to over 200 mmHg. This hypertensive crisis was managed with nicardipine and alprostadil combined with increased infusion rate of remifentanil and propofol. Thereafter, the patient was hemodynamically stable and the postoperative course was uneventful. Pathological examination identified the tumor as extraadrenal paraganglioma. The possibility of paraganglioma should be considered even in asymptomatic abdominal mass, and adequate precautions are required in such cases.

• Authors: Akihiko Nonaka, Kenzo Makino, Atsushi Furuya, Satomi Suzuki, Fumiaki Tamaki, Nobumasa Asano, Kodai Ikemoto
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 61 Issue 6 Pg. 614-6 (Jun 2012) ISSN: 0021-4892 [Print] Japan
• PMID: 22746026 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Anesthesia, Epidural (adverse effects)
• Anesthesia, General (adverse effects)
• Diagnosis, Differential
• Female
• Gastrointestinal Stromal Tumors (diagnosis)
• Humans
• Hypertension (etiology)
• Middle Aged
• Paraganglioma, Extra-Adrenal (complications, diagnosis)
• Retroperitoneal Neoplasms (complications, diagnosis)