[Perioperative treatment of a patient with ectopic ACTH-producing pheochromocytoma].
This report deals with perioperative treatment for a very rare disease called ectopic ACTH-producing pheochromocytoma in a 55-year-old woman. She showed high norepinephrine, cortisol, and ACTH levels, and diagnosed as ectopic ACTH-producing pheochromocytoma, by MIBG scintigraphy. An alpha-blocker and fluid loading for pheochromocytoma, and an adrenal cortex hormone synthesis inhibitor for Cushing's syndrome, were given simultaneously as a preoperative treatment. Propofol with nitrous oxide-oxygen-sevoflurane and epidural anesthesia were used for excision of the tumor, and the procedure was performed without any marked changes in hemodynamics. Although ectopic ACTH-producing pheochromocytoma is a very rare disease, it can be managed safely by appropriate preoperative treatment for pheochromocytoma and Cushing's syndrome.
Shigekawa
Takako
T
Department of Anesthesiology, National Hospital Organization Okayama Medical Center, Okayama.
Sato
Tetsufumi
T
Mizobuchi
Satoshi
S
Nakatsuka
Hideki
H
Yokoyama
Masataka
M
Morita
Kiyoshi
K
D000310:Adrenal Gland Neoplasms / Q000378:metabolism / Q000601:surgery*; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000324:Adrenocorticotropic Hormone / Q000096:biosynthesis*; D000767:Anesthesia, Epidural; D000769:Anesthesia, Inhalation; D017292:Doxazosin / Q000008:administration & dosage*; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008797:Metyrapone / Q000008:administration & dosage*; D008875:Middle Aged; D019990:Perioperative Care; D010673:Pheochromocytoma / Q000378:metabolism / Q000601:surgery*; D016896:Treatment Outcome
D000317:Adrenergic alpha-Antagonists; D004791:Enzyme Inhibitors; D000324:Adrenocorticotropic Hormone; D017292:Doxazosin; D008797:Metyrapone