Anesthetic challenges in a pregnant patient with Von Hippel-Lindau disease: A case report.

Abstract

Von Hippel-Lindau disease (VHLD) is a rare autosomal dominant genetic disorder characterized by the development of highly vascularized tumors, including central nervous system (CNS) hemangioblastomas, pheochromocytomas, and renal cell carcinomas. Pregnancy in patients with VHLD presents unique anesthetic challenges due to tumor-associated risks and physiological changes. This report describes the anesthetic management of a 31-year-old woman with VHLD and twin gestation during active labor at 35 weeks of pregnancy. Despite the advantages of neuraxial anesthesia for cesarean delivery, general anesthesia was selected due to the unavailability of recent imaging and the potential risks of neuraxial techniques in such cases. The case emphasizes the importance of individualized planning, hemodynamic stability, and multidisciplinary collaboration to optimize outcomes for both mother and neonates.