Anaesthetic challenges in surgical excision of phaeochromocytoma

ABSTRACT

Background: Phaeochromocytoma is a rare tumour; which is benign but metabolically active; with a potential for malignancy. This tumour of adrenal or extra adrenal origin usually presents as hypertension; which can be sustained or paroxysmal and with lethal complications. Aim: To present an anaesthetic experience during the surgical resection of a phaeochromocytoma. Method: A 26-year old woman with phaeochromocytoma of the right adrenal gland is presented. The tumour was excised under general anaesthesia. The anaesthesia involved the use of continuous infusion of esmolol (an ultra short-acting intravenous cardioselective beta-antagonist) and propofol. The resected tumour was sent for histopathological examination. Results: The tumour was completely excised under general anaesthesia. The haemodynamic changes that occurred during tumour handling were controlled with fentany1;propofol/esmolol infusion. Histopathological findings confirmed phaeochromocytoma. Conclusion: Although; the anaesthetic and surgical management of a phaeochromocytoma could be an uphill task; it is possible in an environment with limit laboratory and intensive care facilities