Abstract
Catecholamine-secreting glomus tumor at the skull base is very rare. A 31-year-old female with headache and hypertension was diagnosed with catecholamine-secreting glomus tumor. Her plasma norepinephrine level was 21,165 pg/ml, and a tumor 50 mm in diameter was found by MRI in the right cervical venous fossa. An adrenergic alpha-blocker was administered three months before the operation as a preoperative circulation control. The tumor was embolized a week before the operation. Anesthesia was maintained with propofol and remifentanil. During the manipulation of the tumor, a cardiac arrest lasting five seconds occurred, but the patient recovered spontaneously. We also controlled the patient's hypertension with nicardipine, switching to norepinephrine after the tumor was removed. Though her consciousness was clear after the operation, she was moved to the ICU with the respirator due to vagal paralysis. On the third day after the operation, we removed her tracheal tube. We measured plasma catecholamine levels and they were decreasing as the treatments were phased. As a result, we were able to successfully accomplish the anesthesia management of the ectopic pheochromocytoma at the skull base.
