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Perioperative management of a patient undergoing resection of interleukin-6 producing pheochromocytoma

BACKGROUND: Pheochromocytomas produce hormones, cytokines, and catecholamines. We report perioperative anesthetic management of a rare interleukin-6 (IL-6)-producing pheochromocytoma. CASE PRESENTATION: A 32-year-old female was scheduled for laparoscopic adrenalectomy for pheochromocytoma. She had a...

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Detalles Bibliográficos
Autores principales: Kuroki, Masahiro, Suzuki, Hiroto, Kurota, Misato, Nakane, Masaki, Kawamae, Kaneyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196126/
https://www.ncbi.nlm.nih.gov/pubmed/34117557
http://dx.doi.org/10.1186/s40981-021-00449-5
Descripción
Sumario:BACKGROUND: Pheochromocytomas produce hormones, cytokines, and catecholamines. We report perioperative anesthetic management of a rare interleukin-6 (IL-6)-producing pheochromocytoma. CASE PRESENTATION: A 32-year-old female was scheduled for laparoscopic adrenalectomy for pheochromocytoma. She had a sustained high fever with elevated serum noradrenaline and IL-6 levels. The persistent high inflammatory state, followed by anemia, malnutrition, and coagulopathy, led us to prepone her date of surgery. During general anesthesia, alpha-blockers allowed hemodynamic fluctuations to be controlled. During surgery, simultaneous increases in noradrenaline and IL-6 levels were observed, which rapidly declined after tumor removal. Her postoperative course was uneventful, without pulmonary edema caused by cytokine storms. CONCLUSIONS: The conventional pheochromocytoma strategy allowed surgical removal of an IL-6-producing pheochromocytoma under general anesthesia. However, management of high inflammatory states that induce anemia and coagulopathy is necessary.