PMC4701822_01
Axial (left) and sagittal (right) T1-weighted magnetic resonance images with gadolinium demonstrating a left cerebellar hemangioblastoma with a mural node causing obstructive hydrocephalus.
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Magnetic resonance imaging (MRI) showed areas of abnormal enhancement in the left cerebellum, which were revealed to be a hemangioblastoma with mass effect causing obstructive hydrocephalus (Fig. 1).
Abdominal CT scan showing bilateral adrenal tumors (the right and left masses were 5.5 and 1.5 cm in diameter, respectively).
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Computed tomography (CT) of the abdomen revealed bilateral suprarenal tumors with a cyst and a 5-cm-diameter tumor in the left kidney (Fig. 2).
Intraoperatively, we administered propofol, remifentanil, phentolamine, landiolol, and a calcium blocker to control blood pressure. At the times of intubation, skin incision, manipulation of the adrenal tumor, the patient's blood pressure rose to 220 mmHg, and serum adrenaline level increased from 4885 pg/mL to 16,148  pg/mL (~60-500 pg/mL). However, after adrenalectomy, serum adrenaline level decreased to 191 pg/mL, and blood pressure returned to normal.
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However, after adrenalectomy, his serum adrenaline level decreased to 191 pg/mL, and the patient's blood pressure returned to normal (Fig. 3).