Intraoperative hypertensive crisis due to a catecholamine‐secreting esthesioneuroblastoma. Issue 6 (6th April 2015)

• Record Type: Journal Article
• Authors: Salmasi, Vafi; Schiavi, Adam; Binder, Zev A.; Ruzevick, Jacob; Orr, Brent A.; Burger, Peter C.; Ball, Douglas W.; Blitz, Ari M.; Koch, Wayne M.; Ishii, Masaru; Gallia, Gary L.; Andersen, Peter
• Is Part Of: Head & neck. Volume 37:Issue 6(2015:Jun.)
• Page Start: E74
• Page End: E80
• Publication Date: 2015-04-06
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.23907
• Languages: English
• ISSNs: 1043-3074

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="hed23907-sec-0001" sec-type="section"> <title>Background</title> <p>Although uncommon, esthesioneuroblastomas may produce clinically significant amounts of catecholamines.</p> </sec> <sec id="hed23907-sec-0002" sec-type="section"> <title>Methods</title> <p>We report a patient with a catecholamine‐secreting esthesioneuroblastoma who developed an intraoperative hypertensive crisis.</p> </sec> <sec id="hed23907-sec-0003" sec-type="section"> <title>Results</title> <p>A patient with a history of hypertension was referred to our skull base center for management of a residual esthesioneuroblastoma. A staged endonasal endoscopic approach was planned. At the conclusion of the first stage, a hypertensive crisis occurred. Workup revealed elevated levels of serum and urinary catecholamines. The patient was treated with alpha adrenoceptor blockade before the second stage. Serum catecholamine levels after this second stage were normal. On immunohistochemical analysis, the tumor cells were found to be positive for tyrosine hydroxylase, the rate limiting enzyme in catecholamine synthesis, and achaete‐scute homologue 1, a transcription factor essential in the development of olfactory and sympathetic neurons.</p> </sec> <sec id="hed23907-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Catecholamine production should be considered in the differential of unexpected extreme hypertension during surgical resection of esthesioneuroblastoma. © 2015 Wiley Periodicals, Inc. <italic>Head Neck</italic> 37: E74–E80, 2015</p> </sec> </abstract>