Proteus syndrome: what the anesthetist should know ★★★

• Proteus syndrome is a rare hamartomatous disorder causing asymmetric overgrowth of multiple body tissues.
• Affected patients often need orthopedic or reconstructive plastic surgeries for physical rehabilitation.
• The musculoskeletal and soft tissue overgrowth can create problems in airway management and regional anesthesia procedures.
• Visceral involvement such as cystic lung degeneration of lung can compromise respiratory functions.
• As patients are postoperatively prone to deep venous thrombosis, prophylaxis should be considered.

Proteus syndrome (PS), a rare hamartomatous disorder, manifests itself in asymmetric and disproportionate overgrowth of multiple body tissues. Because of complexity of the disorder, the anesthetic problems encountered during patients’ perioperative management are very varied. We discuss the case of a 14-year-old adolescent boy diagnosed with PS who underwent corrective osteotomy of right knee joint under subarachnoid block. The salient points the anesthetists need to be aware of while caring for patients with PS are highlighted.