Perioperative management of the patient with pheochromocytoma and Von Recklinghausen's disease

Abstract

Introduction: In patients with neurofibromatosis type 1 the prevalence of pheochromocytoma is high, the risk of having a pheochromocytoma is 10 times higher than in the general population.

Objective: Describe the case of a patient with infrequent pathologies that requires the assistance of experts for its management before and in the follow-up after surgery.

Presentation of the case: Male, 38 years old with a history of NF1, evaluated for 4 months of headache, abdominal pain and difficult-to-control arterial hypertension. A diagnosis of pheochromocytoma was made and adrenalectomy was defined with perioperative hospitalization to control blood pressure levels with alpha and beta blockers.

Discussion: The management of pheochromocytoma is surgical resection. For the surgical procedure, patients must receive alpha blockade at least 10 days before the procedure and beta blockers 3 days before. Catecholamine crises can occur intraoperatively due to mechanical stress of the tumor. when being manipulated, psychological stress and medication.

Conclusion: Surgical treatment is the choice and must be performed by an interdisciplinary group to ensure adequate control of blood pressure figures in the perioperative period and thus avoid complications.