Problems with the management of a case of phaeochromocytoma: case report

Abstract

A 29 year old woman was referred from Jos University Teaching Hospital (J. U.TH.) with a provisional diagnosis of phaeochromocytoma. She had presented with recurrent headaches, palpitations, excessive sweating, dizziness, syncope and hypertension. She was treated with phenoxybenzamine and propranolol for six weeks before the drugs were discontinued. This followed conflicting results of investigations done. The return of persistent and severe symptoms led to recommencement of the drugs and surgical intervention after four weeks. A general anaesthetic technique was used. The surgery was complicated by intraoperative hypertension and hypotension. Phentolamine was used to manage intraoperative hypertension. Postoperative complications included shivering, fatigue and paralytic ileus. The report emphasizes the need to take clinical findings into consideration in interpreting results of investigations. It also illustrates the anaesthetic experience for excision of a phaeochromocytoma.