Anaesthesia and unexpected phaeochromocytoma

Abstract

An unexpected phaeochromocytoma represents one of the most serious events in anaesthesia, and unless well managed, carries a very high mortality. Although the problem is not common, anaesthetists may be faced with an unexpected phaeochromocytoma either in intensive care, or as a complication of almost any surgical procedure. Phaeochromocytoma is frequently undiagnosed as it may present with a bewildering array of symptomatology (Table I) and patients may be normotensive or even hypotensive, depending on the nature and expression of the tumour. Preoperative absence of symptoms does not exclude the diagnosis. Patients may also present with a variety of medical emergencies. The most hazardous presentation is that of phaeochromocytoma multisystem crisis which carries a very high mortality.