title: [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: Department of Anesthesia, Yamanashi Prefectural Central Hospital, Kofu 400-8506.
authors: Akihiko
authors: A
authors: Nonaka
authors: Kenzo
authors: K
authors: Makino
authors: Atsushi
authors: A
authors: Furuya
authors: Satomi
authors: S
authors: Suzuki
authors: Fumiaki
authors: F
authors: Tamaki
authors: Nobumasa
authors: N
authors: Asano
authors: Kodai
authors: K
authors: Ikemoto
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000768:Anesthesia, General / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008875:Middle Aged; D010236:Paraganglioma, Extra-Adrenal / Q000150:complications* / Q000175:diagnosis; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000175:diagnosis