We present the case of a 20-month-old patient with a ganglioneuroblastoma, who had received two cycles of chemotherapy, and in whom it was decided to resect the tumor via thoracotomy. It was found that the tumor was firmly adhered to the aortic arch, left carotid artery and roots of thoracic nerves, however a 99% tumor resection was achieved. We want to highlight the importance of this anesthetic challenge that this case represented in the perioperative period due to the delicate state of the patient as well as the abundant use of hemodynamic monitoring technology throughout the procedure.