title: Anesthetic management of a patient with undiagnosed paraganglioma -a case report-.
abstract: Retroperitoneal paragangliomas are uncommon neuroendocrine tumors which are derived from extra-adrenal paraganglioma with various clinical signs and symptoms. Although most extra-adrenal paragangliomas are histologically benign, some tumors can synthesize and secrete excess catecholamine from the tumor. Excessive production of catecholamine causes numerous cardiovascular manifestations such as severe hypertension, cardiomyopathy, cardiac arrhythmias, and even multiorgan failure. It can lead to high risks of morbidity and mortality, especially in patients who are unrecognized or not adequately prepared. We present a female patient who was preoperatively undiagnosed of secreting retroperitoneal paraganglioma that caused cardiac tachyarrhythmia and severe intraopertive hypertension not controlled by usual antihypertensive agents. A secreting extra-adrenal paraganglioma should be included in differential diagnosis for patient who have incidentaloma and show wide range of hypertension with hemodynamic instability that is not well controlled by common antihypertensive drugs.
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Han
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: Yee-Suk
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Yoo
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.
authors.forename: Tae Kwane
authors.initials: TK
authors.lastname: Kim
keywords: Catecholamine; Hypertensive crisis; Paraganglioma