Title : Undiagnosed paraganglioma complicated by intraoperative ventricular fibrillation and takotsubo-like cardiomyopathy: A case report
Abstract:
Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that may secrete catecholamines, leading to diverse clinical manifestations, especially cardiovascular disorders such as hypertension, arrhythmias, and cardiomyopathy. These tumors carry significant morbidity and mortality risks if not detected or optimally managed prior to surgery. We report a case of a female patient with an undiagnosed retroperitoneal paraganglioma who developed intraoperative ventricular tachycardia and followed by ventricular fibrillation, necessitating advanced cardiac life support. Postoperatively, the patient developed acute heart failure with severe left ventricular systolic dysfunction consistent with Takotsubo-like cardiomyopathy secondary to pheochromocytoma. This case highlights the major perioperative challenges posed by PPGLs and underscores the critical importance of a multidisciplinary approach involving anesthesiology, surgery, endocrinology, and radiology to ensure timely diagnosis, optimize preoperative preparation, and implement appropriate perioperative anesthetic strategies, thereby reducing the risk of catastrophic cardiovascular events.
Keywords: Undiagnosed paraganglioma, ventricular tachycardia, catecholamine-induced cardiomyopathy.
