Pheochromocytoma Resection in a Patient With Chronic Thromboembolic Pulmonary Hypertension and Thrombocytopenia

Abstract

PHEOCHROMOCYTOMAS are rare catecholamine-secreting neuroendocrine tumors that can produce life-threatening cardiovascular instability. 1 Lenders JW Eisenhofer G Mannelli M et al. Phaeochromocytoma. Lancet. 2005; 366: 665-675 Abstract Full Text Full Text PDF PubMed Scopus (1279) Google Scholar ,2 Naranjo J Dodd S Martin Y. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth. 2017; 31: 1427-1439 Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar Preoperative management with alpha-blockade and intravascular volume expansion are crucial to intraoperative hemodynamic management, given the risk of catecholamine surges with induction of anesthesia, intubation, surgical incision, insufflation, and tumor manipulation. Intraoperative pheochromocytoma resection management focuses on the goals of maintaining hemodynamic stability in the face of catecholamine surge. After resection, patients are at risk of systemic hypotension related to catecholamine withdrawal, especially in highly active pheochromocytomas. 3 Aguirre MA Lynch I Hardman B. Perioperative management of pulmonary hypertension and right ventricular failure during noncardiac surgery. Adv Anesth. 2018; 36: 201-230 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar