Malignant hypertension during cryoablation of an adrenal gland tumor.

The authors report a case of hypertensive crisis during cryoablation of an adrenal metastasis. This case is of particular interest not only because of the nature of the complication but also because of the timing of the hypertensive crisis. Based on their observations, the authors suggest that it may be prudent to pretreat this patient population with alpha-adrenergic blocking medications (eg, phenoxybenzamine), as is typically done for patients with neuroendocrine tumors such as pheochromocytoma. Preemptive intervention with these medications requires close collaboration between radiology and anesthesia care teams.