Unmasking the Hidden Threat: A Case Report of the Anesthetic Management of a Catecholamine-Secreting Tumor in Pregnancy.

Catecholamine-secreting tumors (CSTs) are rare but serious conditions, particularly in pregnancy, as they significantly increase the risk of maternal and fetal morbidity and mortality. Diagnosing CSTs in pregnant women with hypertension is challenging due to overlapping symptoms, with more common conditions like preeclampsia. In this report, we present the case of a 24-year-old hypertensive primigravida, diagnosed with a CST at 27 weeks of gestation following previous hypertensive episodes. Her management involved pretreatment with alpha- and beta-blockers to control hypertension, followed by an elective cesarean section at 32 weeks. The combined neuraxial anesthesia approach ensured stable hemodynamics during surgery, and a healthy newborn was delivered. Three months after the delivery, tumor resection was performed, confirming the diagnosis of multicentric sympathetic paraganglioma. This case highlights the intricate challenges of managing CSTs during pregnancy. The survival of both the mother and the fetus relies heavily on timely diagnosis, appropriate medical interventions, optimal perioperative management, and the precise timing of both delivery and surgical procedures. These decisions should be made on an individual basis, and close collaboration between obstetricians, endocrinologists, anesthesiologists, and surgeons is essential. Given the rarity of CSTs in pregnancy, this case highlights the importance of maintaining a high index of suspicion in hypertensive pregnant patients and the need for individualized care strategies.