Asymptomatic Presacral Paraganglioma: Management of an Unpredictable Intraoperative Finding

Samara, Athina A.; Symeonidis, Dimitrios; Anagnostou, Athanasios; Tepetes, Konstantinos

doi:10.1055/s-0040-1712545

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Following an R0 resection, patient surveillance requires plasma catecholamines and free metanephrines, urinary levels of catecholamines, VMA, total and fractionated metanephrines. These should be measured every three months during the first year, every six months until the third year, and then annually for up to 10 years (8). CT abdominal scan, abdominal MRI, and scintigraphy performed with 123-I labeled metaiodobenzylguanidine (MIBG) is essential in the assessment surveillance of the patients for metastatic disease, tumor recurrence, or delayed appearance of multiple primary tumors (15).…”

Section: Discussionmentioning

confidence: 99%

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

et al. 2021

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Paragangliomas are extremely rare neuroendocrine tumors. We report a case of a 44-year-old man with hypertension who presented a tumoral mass located retroperitoneally at the aortic bifurcation which included both the common iliac arteries and the posterior left iliac vein, who experienced an unpredictable intraoperative cardiac arrest with electromechanical dissociation at 5 min after laparotomy. After successful resuscitation and hemodynamic stability, the lesion was fully excised. In the course of tumor manipulation, the patient developed a major hypertensive crisis with peak systolic blood pressure over 280 mmHg. Pathologic examination revealed the presence of diffuse proliferation of large and medium-sized mature adipocytes consistent with paraganglioma diagnosis. The patient was discharged at home on the seventh postoperative day. He did not present evidence of recurrence at the one-year follow-up. In conclusion, paragangliomas can require particular management due to their location but also due to their capacity to discharge substances which might induce life-threatening intraoperative complications.

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Section: Discussionmentioning

confidence: 99%

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

et al. 2021

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A Rare Case of Intra-Renal Paraganglioma in a Child Masquerading as Renal Cell Carcinoma

Tripathy

Manekar

Sahoo

et al. 2023

Indian Pediatrics Case Reports

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Background: Renal cell carcinomas (RCCs) are rare in children, accounting for around 2% of all pediatric renal tumors. Paragangliomas are extra-adrenal locations of phaeochromocytomas. They originate from chromaffin cells arising along the sympathetic paraganglia and are secretory in most cases. Sequential imaging is often required to ascertain the etiology of a renal mass; ultrasound (USG), contrast-enhanced computerized tomography scan (CECT), and magnetic resonance imaging (MRI). Tissue diagnosis is confirmatory. Clinical Description: An 11-year-old girl presented with a right-sided abdominal and flank pain that was dull aching and nonradiating. She had no history of jaundice, hematuria, dysuria, bowel symptoms, sweating, palpitations, or syncope. The vitals were stable, without tachycardia or hypertension. No abnormal findings were found on clinical examination. Initially, the possibility of a renal stone was considered. Management and Outcome: Baseline blood tests were normal. Abdominal USG detected a heterogeneous mass in the right kidney. CECT ascertained that it was very vascular and exhibited contrast enhancement, suggesting a renal tumor. MRI showed that the right renal artery was acting as the feeding vessel to the tumor. RCC was suspected based on imaging. The vascular nature prevented us from performing a Tru-cut biopsy. A right-sided nephrectomy was planned, preceded by angiography and embolization of the right renal artery to reduce vascularity. Intraoperative episodes of hypertension were noted. Gross appearance suggested RCC; however, histopathology revealed evidence of an intrarenal PGL. Conclusions: Diagnosing a nonfunctional PGL in an asymptomatic patient is challenging and may only be possible by intraoperative histopathology.

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Asymptomatic Presacral Paraganglioma: Management of an Unpredictable Intraoperative Finding

Cited by 2 publications

References 14 publications

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

A Rare Case of Intra-Renal Paraganglioma in a Child Masquerading as Renal Cell Carcinoma

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