Pheochromocytoma is a tumor that arises from the chromaffin cells of the adrenal medulla, which is histologically impossible to differentiate from paragangliomas that can arise outside the adrenal gland, in addition to the low incidence and high complexity in the differential diagnosis. It is a challenge for both the anesthesiologist and the surgical team, due to possible complications that could occur in the operating room. It should be rigorously evaluated and alpha and beta blockade must be started at least two weeks before the surgical procedure. Maintaining a good anesthetic plane and avoiding noxious stimuli wich may trigger sympathetic stimuli are the main objectives of this procedure. Due to the complexity of hemodynamics during surgery constant and open communication between the surgical team is essential.
