Excision of a suspected retroperitoneal, duodenal duplication cyst was performed in a pre-operatively normotensive patient under combined epidural and general anaesthesia.Intraoperatively, the cystic tumour was discovered to be a retroperitoneal mass, free from duodenal or adrenal origin.Development of severe arrhythmias, ST sara stedy stand aid segment changes and hypertensive spikes during cyst handling and dissection suggested the possibility of a catecholamine-secreting tumour.
These were managed effectively with pharmacological agents.Subsequently, histopathology of the specimen revealed a powell and mahoney bloody mary mix paraganglioma.Vasoactive tumour has to be suspected in every patient undergoing anaesthesia for retroperitoneal cystic lesion.