Laparoscopic management of paraganglioma in a pregnant woman: a case report

Radfar, Mohammad Hadi; Shakiba, Behnam; Afyouni, Amir; Hoshyar, Hassan

doi:10.1590/s1677-5538.ibju.2017.0698

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…PPGL is misdiagnosed in almost 30% of hypertensive pregnancies and is frequently recognized after an acute or severe complication [ 8 ], as described in case 1. Accordingly, the actual prevalence of PPGL should be higher than reported [ 9 ].…”

Section: Discussionmentioning

confidence: 87%

Pheochromocytoma/Paraganglioma (PPGL): A Misdiagnosed Cause of Hypertension during Pregnancy

Giorgi,

Aroucha,

Favreto

et al. 2024

Case Reports in Obstetrics and Gynecology

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Hypertension (HT) during pregnancy is not an infrequent obstetric problem, reaching a prevalence of 5-10%. This condition is highly associated with both maternal and fetal complications if not precisely diagnosed and managed. Even though primary HT, obesity, and preeclampsia are the main causes of HT in this period, other less familiar conditions must be considered during the investigation. Pheochromocytoma and paraganglioma (PPGL) are chromaffin cell tumors that produce, store, and secrete catecholamines, leading to HT and other adrenergic manifestations. Recognition of PPGL is crucial since misdiagnosis and improper management can lead to high morbidity and mortality, particularly during pregnancy. We report on two cases of PPGL diagnosed during pregnancy with different managements. Case 1 is a 25-year-old female at 31 weeks of first pregnancy, whose severe HT and life-threatening symptoms prompted an emergency delivery without previous confirmation or medical treatment of a suspected PPGL. After confirmation, a right adrenal PPGL was surgically resected 4 months later, following 15 days of medical therapy. Case 2 is a 22-year-old female at 18 weeks of pregnancy whose symptomatic PPGL was resected in the second trimester. A next-generation sequencing panel, including 23 PPGL-related genes, found no germline pathogenic variants (GPVs) in case 1 and an exon 1-4 germinative heterozygous deletion of the MAX gene in case 2. Despite the different medical approaches, both cases had satisfactory outcomes. Although uncommon, PPGL should be considered in the differential diagnosis of HT in pregnancy since missing the diagnosis and failing to introduce appropriate and timely treatment may lead to dramatic consequences for the mother and fetus. PPGL diagnosed during reproductive age is likely to result from GPV, prompting genetic investigation and counseling.

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Section: Discussionmentioning

confidence: 87%

Pheochromocytoma/Paraganglioma (PPGL): A Misdiagnosed Cause of Hypertension during Pregnancy

Giorgi,

Aroucha,

Favreto

et al. 2024

Case Reports in Obstetrics and Gynecology

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“…A PubMed search for reports on laparoscopic surgery for abdominal PGL with paraganglioma/laparoscopic revealed 12 case reports, including this case, in a 10‐year period from 2010 to 2020 (Table 1). 18‐28 The average age was 44.9 years (22‐72), and the male:female ratio was 5:7. Laparoscopic approaches consisted of the transperitoneal approach in 11 cases and transthoracoabdominal approach in 1 case.…”

Section: Discussionmentioning

confidence: 99%

A patient with paraganglioma undergoing laparoscopic resection: A case report

Yoshii

Hayashi

Tajiri

et al. 2021

Clinical Case Reports

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“…Surgical resection is the first choice for the treatment of PGL, and laparoscopic resection is often suitable for smaller (< 7 cm) tumors[ 9 , 10 ]. In recent years, laparoscopic techniques have been used to successfully remove large retroperitoneal tumors one after another[ 11 - 13 ]. How to design the surgical plan was another great challenge in this case.…”

Section: Discussionmentioning

confidence: 99%

Combined thoracoscopic and laparoscopic approach to remove a large retroperitoneal compound paraganglioma: A case report

Liu¹,

Wen²,

Li³

et al. 2021

WJCC

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BACKGROUND Paragangliomas (PGLs) are rare catecholamine-secreting neuroendocrine tumors, which often present with secondary hypertension. The most common location is the retroperitoneal space. For the first time, we report a rare case of large retroperitoneal compound PGL, and we have innovatively applied a new surgical plan to completely remove the tumor. CASE SUMMARY A 55-year-old middle-aged man was admitted to the hospital for fluctuating blood pressure for more than 1 year with intermittent headache. He suffered dozens of attacks every day. Blood and urine catecholamines were elevated, somatostatin receptor imaging was positive, and the diagnosis of PGL was clear. The imaging examination revealed a large tumor on the right front of the mediastinal spine at the level of T10-L1 (the posterior space of the right phrenic foot). For the first time in our department, a combined thoracoscopic and laparoscopic operation was used to detect and remove large tumors. CONCLUSION This is the first reported case of using a thoracoscopic and laparoscopic approach simultaneously to remove a large retroperitoneal compound PGL, which may provide a new surgical approach for similar cases.

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Laparoscopic management of paraganglioma in a pregnant woman: a case report

Cited by 6 publications

References 8 publications

Pheochromocytoma/Paraganglioma (PPGL): A Misdiagnosed Cause of Hypertension during Pregnancy

Pheochromocytoma/Paraganglioma (PPGL): A Misdiagnosed Cause of Hypertension during Pregnancy

A patient with paraganglioma undergoing laparoscopic resection: A case report

Combined thoracoscopic and laparoscopic approach to remove a large retroperitoneal compound paraganglioma: A case report

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