title: Unexpected pheochromocytoma presenting as a pancreatic tumor: A case report.
abstract: A 54-year-old female presented with a large pancreatic tumor of the tail during a regular physical examination. The patient underwent surgical intervention and the surgeon identified that the tumor originated from the retroperitoneal region. Markedly severe hemodynamic fluctuations occurred during the manipulation of the tumor and continued to occur subsequent to the tumor being removed. The vital signs were adequately managed and the surgery was successful without complications. The patient was discharged without any sequelae days later. The pathology report indicated a diagnosis of pheochromocytoma. Unexpected pheochromocytoma may lead to a fatal hypertensive crisis with catastrophic sequelae during surgery. The peri-operative management of pheochromocytoma remains a complicated challenge that requires intensive pre-operative preparation and vigilant peri-operative care. For surgeons and anesthesiologists who may encounter an unexpected hypertensive crisis during abdominal tumor surgery, undiagnosed pheochromocytoma should always be considered.
authors.affiliation: Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 11490, Taiwan, R.O.C.
authors.forename: Yi-Hsuan
authors.initials: YH
authors.lastname: Huang
authors.forename: Wen-Jinn
authors.initials: WJ
authors.lastname: Liaw
authors.forename: Chang-Po
authors.initials: CP
authors.lastname: Kuo
authors.forename: Zhi-Fu
authors.initials: ZF
authors.lastname: Wu
authors.forename: Chen-Hwan
authors.initials: CH
authors.lastname: Cherng
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Huei-Chi
authors.initials: HC
authors.lastname: Horng
authors.forename: Shun-Tsung
authors.initials: ST
authors.lastname: Huang
keywords: intra-abdominal tumor; pancreatic tumor; pheochromocytoma