Case Report

Retroperitoneal Paraganglioma: Clinical Presentation and Treatment Outcomes in Two Patients

Patricio Marchiñena Garcia, Alberto Jurado, Luis Uria, Jose Costabel, Mariana Isola, Oscar Damia and Guillermo Gueglio
World Journal of Pathology 2013, 2:14

Abstract

Introduction

Paragangliomas are rare neuroendocrine tumors that arise from extra-adrenal autonomic ganglia. The aim of this paper is to analyze the presentation, diagnosis and treatment outcomes of two patients with retroperitoneal paraganglioma treated in our hospital.

Case Presentation

The first case is a 34 year old female, ASA status 1, who underwent elective surgery for removal of retroperitoneal tumor. Laparoscopic surgical resection was decided. Minimal tumor manipulation was followed with severe hypertension. Due to high suspicion of the presence of a catecholamine-secreting tumor, intravenous antihypertensive drugs were given. The patient coursed with hypotension and acute pulmonary edema after the surgery. Transthoracic echocardiogram showed apical ballooning with impaired ejection fraction of the left ventricle. After 3 days in Cardiac Care Unit the patient was discharged. The second case is a 25 years old male, with large history of refractory hypertension who was admitted in our hospital with sweating, palpitations, dizziness and hypertension. Catecholamine dosage was performed in plasma and urine and the results were inconclusive. The CT scan showed a right hypoplastic kidney and a 2.5 x 1.9 cm nodular mass located between his left renal artery and vein. Because of the high suspicion of paraganglioma we decided the tumor excision. The patient recovered without complications, and was discharged 4 days after surgery. Final surgical pathology demonstrated in both cases a paraganglioma.

Conclusions

The paraganglioma is a rare tumor associated with high morbidity and mortality when the diagnosis is made intraoperatively.

Key words

Extra-adrenal pheochromocytoma, Retroperitoneal mass, diagnosis.

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