Anesthesia for Removal of Asymptomatic Pheochromocytoma

A 45-year-old male patient with asymptomatic pheochromocytoma was anesthetized for the surgical removal of the tumor. The tumor was unexpectedly discovered by abdominal echography. The patient had received medication for the control of hyper-glycemia but there was no sign of hypertension. During surgery, we achieved stable circulation by routine preoperative and intra-operative anesthetic procedures used for patients with symptomatic pheo-chromocytoma. After surgery, glucose tolerance was improved. The present case suggests that, even if asymptomatic, the same preoperative manage-ment procedures used for the removal of symptomatic pheochromocytoma are desir-able. We propose a classification of pheochromocytomas useful for anesthetic management during surgical removal. It is suggested that the degree of difficulty in intra-operative anesthetic management depends on the type and concentration of plasma catecholamines.