Renal hilar pheochromocytoma: a case report

Abstract

Paraganglioma is a rare tumor arising from undifferentiated cells of the primitive neural crest. These tumors are most commonly found in the adrenal gland, other localisations are also possible. A 58-year-old woman who presented with history of left lumbar pain, headache, hypertension, palpitation and sweating was found to have a secreting left renal hilar pheochromocytoma. Radical excision of the tumor was therefore undertaken and her hypertension was controlled. From the case report and literature review, the authors suggest a diagnostic and therapeutic strategy for the management of ectopic localization of pheochromocytoma.

Different Ectopic Endocrine Tumors on Renal Hilum Detected by 68Ga-DOTATATE PET

“…4 There are a few reports of ectopic adrenal tumors and paraganglioma in the renal hilar region. [5][6][7][8] So, it needs to be included in the differential diagnosis of tumors involving the renal hilum to avoid misdiagnosis leading to wrong surgery. Patients with endocrine tumors have a wide variety of clinical manifestations, so searching for the causative lesions accurately is particularly important for clinical diagnosis.…”

“…Paraganglioma arising from the extra-adrenal autonomic paraganglia, which usually secrete catecholamines, is located in the sympathetic paravertebral ganglia, and the para-aortic region is the most common site 4. There are a few reports of ectopic adrenal tumors and paraganglioma in the renal hilar region [5][6][7][8]. So, it needs to be included in the differential diagnosis of tumors involving the renal hilum to avoid misdiagnosis leading to wrong surgery.…”

Paraganglioma in the renal pelvis

“…Ahallal et al. [3] reported a 58‐year‐old woman with renal hilar pheochromocytoma; and Bhandarkar et al. [4] reported two patients with renal hilar pheochromocytomas treated with laparoscopic resection successfully.…”

“…Radical removal of the kidney or tumor is the optimal surgical procedure to treat paragangliomas in the renal pelvis. The criteria of malignancy cannot be easily distinguished histologically, but a metastasis in follow-up is a sign of malignancy [3].…”

“…Chandra et al [2] reported one case of renal hilar paraganglioma complicated with renal artery stenosis. Ahallal et al [3] reported a 58-year-old woman with renal hilar pheochromocytoma; and Bhandarkar et al [4] reported two patients with renal hilar pheochromocytomas treated with laparoscopic resection successfully. Melegh et al [5] reported a case of giant cystic pheochromocytoma in the renal hilum; however, there are few reports on renal pelvic paraganglioma.…”