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Anaesthetic Management of a Labrador Retriever Undergoing Adrenalectomy for Phaeochromocytoma Excision, a Case Report.

Front Vet Sci

March 2022

Anaesthesiology and Pain Therapy Division, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Perioperative management of cases undergoing phaeochromocytoma removal should aim at normalising blood pressure and heart rate, restoring volume depletion, and preventing catecholamine release induced by surgical manipulation. In this case report, a novel pharmacological approach in a dog undergoing surgical tumour excision is described. A 7-year-old 25-kg spayed female Labrador Retriever presented for repeated episodes of generalised weakness, pale mucous membranes, tachycardia, tremor, panting, vomiting, and hypertension over the last month was referred for surgical treatment of a left-sided adrenal tumour with invasion of the caudal vena cava.

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Pheochromocytoma is a rare tumor during childhood, originating from the chromafine tissue. The clinical presentation can be variable and assembling many other diseases. This tumor submits specific care problems.

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Article Synopsis
  • MEN2 is a hereditary cancer syndrome linked to proto-oncogene mutations, with two main forms: MEN2A and MEN2B, both typically featuring medullary thyroid carcinoma (MTC) and pheochromocytoma (Pheo).
  • A 7-year-old girl with a history of neurofibroma presented with a unique MEN2B case, exhibiting hyperparathyroidism (HPTH) and other complications, including bilateral thyroid nodules and a pelvic tumor.
  • Genetic analysis revealed a new germline deletion, and surgical interventions confirmed bilateral MTC, lymph node metastases, and hyperplastic parathyroid tissue linked to this atypical syndrome phenotype.
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Background: Pheochromocytomas are rare tumors originating in chromaffin cells which predominantly are located in adrenal glands. Sustained or paroxysmal hypertension (HT) is the most frequent sign of pheochromocytoma. In some cases, it is associated with the classic triad including episodic headaches, sudoresis, and tachycardia; however, we present a case of pheochromocytoma with first presentation of cardiomyopathy.

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A previously healthy 7-year-old male presented with hypertensive emergency, hypokalemia, and elevated plasma renin activity and aldosterone levels. There was no evidence of virilization or cushingoid features. MRI of the abdomen revealed a large (5 × 5 × 3 cm) peripherally enhancing, heterogeneous mass arising from the left adrenal gland.

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