Anaesthetic Management of Secretory Paraganglioma With Cyanotic Heart Disease: Double Trouble

Paragangliomas (PGL) in paediatric patients are rarely diagnosed with neuroendocrine tumours. Anaesthetic management of paraganglioma is challenging due to exaggerated haemodynamic alterations. Further associated cardiovascular diseases like congenital cyanotic heart disease (CCHD) with paragangliomas make its management daring and if not properly managed can increase morbidity. We herein discuss the successful anaesthetic management of a 10-year-old child with paraganglioma and associated atrial septal defect (ASD) with pulmonary stenosis (PS) for adrenalectomy. Overlapping the clinical spectrum between CCHD and catecholamine-secreting tumour makes the case very challenging. Management of the patient with CCHD and PGL needs a multidisciplinary approach, and intensive vigilance and monitoring are needed for the successful management of such challenging cases.