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Editor Yu states that, as in many retrospective studies, our work1 creates the impression that all phaeochromocytomas are more or less the same; an impression that Yu wishes to challenge. We thank Yu for this comment and agree totally. As described by Neumann et al.2, there are different types of catecholamine-producing tumours diagnosed as phaeochromocytomas. In addition, Eisenhofer et al.3 describe histological and clinical differences in patients with phaeochromocytomas with an underlying diagnosis of multiple endocrine neoplasia type 2 (MEN2) versus von Hippel–Lindau disease. These two diseases differ in the pattern of catecholamines produced and the resulting plasma concentrations. Patients with MEN2 tend to have tumours that produce primarily adrenaline at high plasma concentrations, even in patients with small tumours3. This heterogeneity in catecholamineproducing tumours leads to the second point. Yu speculates that our study included young patients with small tumours resulting in a low risk of haemodynamic instability. Certainly, our study includes patients whose tumour was found via family screening and who were asymptomatic or had only a few symptoms. However, more than 75 per cent of our patients were symptomatic with typical hypertensive crisis. Furthermore, there have been patients with intraoperative hypertensive episodes and systolic arterial blood pressure increases above 250 mmHg1. As described by Gaujoux et al.4, and in accordance with our own data of more than 500 patients with catecholamineproducing tumours, tumour size and age do not correlate well with intraoperative haemodynamic instability. Overall, we thank Yu for commenting on our case series. However, our interpretation of the data is not that we took care of patients who had a low risk for haemodynamic instability and therefore did not need an α-receptor blockade, but that intraoperative haemodynamic disturbances occurred regardless of αreceptor blockade. Even worse, longlasting α-receptor blockade increases the risk of intraoperative and postoperative arterial hypotension, which can result in the complications and side effects outlined in our article. H. Groeben Department of Anaesthesiology, Critical Care Medicine and Pain Therapy, Kliniken Essen-Mitte, Essen, Germany