PURPOSE: To report the perioperative management and the serious hemodynamic fluctuations during manipulation of an organ of Zuckerkandl @entity5 in a @entity1 undergoing resection of multicentric @entity9681 . CLINICAL FINDINGS: A 28-yr-old @entity1 who had undergone at age 12 a laparotomy for excision of an @entity9681 complained of paroxysmal @entity10 , occasional sweating and palpitations. The arterial @entity551 ( @entity551 ) was 200/100 mmHg. A 24-hr-urine collection showed @entity2661 5076 microg x 24 hr(-1) (normal < 25 microg x 24 hr(-1)). Computed tomography of the abdomen revealed two retroperitoneal masses, one adjacent to the lower pole of the right kidney and a second larger mass located at the aortic bifurcation in the region of the organ of Zuckerkandl. The @entity1 was scheduled for excision of multiple @entity9681 . He was prepared preoperatively for two weeks with @entity3159 1 mg po q six hours and @entity1169 10 mg tid. Manipulation of the @entity5 was uneventful but manipulation of the Zuckerkandl @entity5 resulted in severe @entity101 episodes with @entity551 ranging from 200/100 to 320/120 mmHg. Surgery was interrupted temporarily; the @entity101 crisis was controlled by the infusion of @entity1854 and by iv @entity5521 and @entity7368 . CONCLUSION: In a @entity1 undergoing resection of recurrent multicentric @entity9681 , severe @entity101 episodes occurred during manipulation of one @entity5 but not during manipulation of the other. This may be attributed to inadequate preparation of the @entity1 , difficult surgical dissection of the large Zuckerkandl @entity1911 , and/or secondary to an excessive and different pattern of release of @entity2661 during manipulation of the Zuckerkandl @entity5 .

Variable hemodynamic fluctuations during resection of multicentric XXXX .

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity1169 :: ('MESH:D011433', 'Chemical') :: ['propranolol'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertensive'] @entity1911 :: ('MESH:D010673', 'Disease') :: ['pheochromocytoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['infrarenal tumour', 'tumour'] @entity9681 :: ('MESH:C565335', 'Disease') :: ['extraadrenal pheochromoctyomas', 'extraadrenal pheochromocytomas', 'extraadrenal pheochromocytoma'] @entity2661 :: ('MESH:D002395', 'Chemical') :: ['catecholamines'] @entity1854 :: ('MESH:D009599', 'Chemical') :: ['sodium nitroprusside'] @entity5521 :: ('MESH:D010646', 'Chemical') :: ['phentolamine'] @entity7368 :: ('MESH:C036604', 'Chemical') :: ['esmolol'] @entity3159 :: ('MESH:D011224', 'Chemical') :: ['prazosin'] @entity10 :: ('MESH:D006261', 'Disease') :: ['headache'] @entity551 :: ('MESH:D007022', 'Disease') :: ['blood pressure', 'BP']
@entity9681 :: (MESH:C565335,Disease) :: ['extraadrenal pheochromocytomas']
