Anesthetic management of a patient with undiagnosed paraganglioma

Pheochromocytomas are catecholamine secreting tumours that arise from the chromaffin cells located within the adrenal medulla. Paragangliomas are also catecholamine secreting tumours arising from extra-adrenal chromaffin cells located along the sympathetic paravertebral ganglia of the pelvis, abdomen, and thorax. The anaesthetic management of both Pheochromocytoma and paraganglioma are same. The anaesthetic care of patients with pheochromocytoma and paraganglioma (PPGL) presenting for surgical resection presents a challenge for the anaesthesiologist, but this challenge will be greatly increased when the tumour is unexpected.