Perioperative care of a child with a germline mutation in succinate dehydrogenase complex, subunit B (SDHB) presenting with synchronous functional paragangliomas in thorax and pelvis

Paragangliomas can either occur sporadically or be associated with a number of germline mutations. Optimal management includes complete surgical resection. Depending on whether the paraganglioma is comprised of functional (catecholamine-secreting) or non-functional neuroendocrine tissue, perioperative care becomes a major consideration. Significant hemodynamic perturbations secondary to catecholamine release can occur during multiple steps in the procedure such as laryngoscopy or tumor manipulation, and require close monitoring and intervention with vasoactive substances. We describe the perioperative care of a child with a succinate dehydrogenase complex, subunit B (SDHB) germline mutation who presented with synchronous functional paragangliomas located in the thorax and pelvis.