Management of a Left Lateral Aortic Paraganglioma During Pregnancy: A Rare Case Report

Abstract

Paragangliomas are rare neuroendocrine tumors mostly diagnosed in young adults. Their association with pregnancy is even rarer, and their impact is even more serious in the absence of adequate management, which may vitally involve maternal and fetal prognosis. In this report, we present a rare case of a left lateral aortic paraganglioma in a pregnant woman in her third trimester during her 31 weeks of gestation, who consulted for a hypertensive peak; the methoxylated derivatives were positive. An abdominal MRI showed a left lateral aortic mass, suggesting a paraganglioma. After a multidisciplinary discussion, the patient underwent laparoscopic surgical resection of the mass after preoperative medical preparation. Pathological examination confirmed the diagnosis of paraganglioma. The overall stay was six days without any short-term complications, including anything related to fetal viability, with a vaginal delivery at 37 weeks of amenorrhea. The patient was followed up for six months with no complications. We highlight the importance of preoperative medical preparation followed by surgical resection in the framework of a multidisciplinary consultation for an improved maternal-fetal prognosis.

Perioperative Management of a Patient with Secreting Paraganglioma Undergoing Cesarean Section

“…Gestational age at the time of diagnosis and symptom control affect the decision on timing of surgery. Several strategies have been described in the literature, namely, whether to promptly perform tumor excision, wait and combine with a cesarean section, or even to delay it until after birth [ 9 , 12 , 13 ]. If diagnosis and optimal medical treatment are achieved in the first trimester, the most recommended option is to proceed to surgery, considering the low risk of inducing premature labor.…”

Ectopic pheochromocytomas in the third trimester: A case report and literature review

“…We found 3 patients who had successfully experienced vaginal delivery after tumor removal before or during pregnancy. [7][8][9] Ten patients underwent cesarean section and had their tumors removed after surgery.…”