Intraoperative hypertensive crisis due to a catecholamine-secreting esthesioneuroblastoma HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK Salmasi, V., Schiavi, A., Binder, Z. A., Ruzevick, J., Orr, B. A., Burger, P. C., Ball, D. W., Blitz, A. M., Koch, W. M., Ishii, M., Gallia, G. L. 2015; 37 (6): E74-E80


Although uncommon, esthesioneuroblastomas may produce clinically significant amounts of catecholamines.We report a patient with a catecholamine-secreting esthesioneuroblastoma who developed an intraoperative hypertensive crisis.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.Catecholamine production should be considered in the differential of unexpected extreme hypertension during surgical resection of esthesioneuroblastoma.

View details for DOI 10.1002/hed.23907

View details for Web of Science ID 000355012000002

View details for PubMedID 25352487