2018
DOI: 10.1155/2018/4058046
|View full text |Cite
|
Sign up to set email alerts
|

Retroperitoneal Paraganglioma-Induced Cardiogenic Shock Rescued by Preoperative Arterial Embolization

Abstract: Background Catecholamine-induced cardiogenic shock is a rare manifestation of paragangliomas. The high mortality rate of this condition makes the immediate, multidisciplinary approach mandatory. Case Report We report a case of an 18-year-old woman with a retroperitoneal secreting paraganglioma, complicated with a cardiogenic shock and an acute adrenergic myocarditis, requiring hemodynamic support and emergency arterial embolization prior to surgical excision, with a favorable outcome. Conclusion Paraganglioma-… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
5

Citation Types

0
8
0

Year Published

2018
2018
2022
2022

Publication Types

Select...
5

Relationship

0
5

Authors

Journals

citations
Cited by 6 publications
(8 citation statements)
references
References 20 publications
0
8
0
Order By: Relevance
“…Recently, numerous new techniques have been employed in surgery for the accurate evaluation of circulating blood volume and goal-directed volume therapy to improve outcomes and reduce hospital stay [45,46]. Furthermore, some preoperative interventional therapies are employed to reduce the risk of intraoperative catecholamine release induced by tumor manipulation [34,[47][48][49].…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…Recently, numerous new techniques have been employed in surgery for the accurate evaluation of circulating blood volume and goal-directed volume therapy to improve outcomes and reduce hospital stay [45,46]. Furthermore, some preoperative interventional therapies are employed to reduce the risk of intraoperative catecholamine release induced by tumor manipulation [34,[47][48][49].…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…Ohara and colleagues reported spontaneous resolution of severe BP fluctuation within 2 weeks after the onset, with normalization of plasma catecholamine levels and no uptake of MIBG into the tumor, secondary to completion of the extensive necrosis [11] . Otherwise, particularly when emergent surgery and medical control using alpha-1 blockade bear high risk, treatment might comprise mechanical circulatory support with a cardiopulmonary device or intra-aortic balloon pump and/or removal of catecholamines by continuous hemodiafiltration [28] , [29] , [30] , [31] , [32] . Alternatively, we chose to perform emergent TAE, which swiftly controlled the critical BP fluctuation, and ultimately performed elective surgical tumor resection.…”
Section: Discussionmentioning
confidence: 99%
“…To our knowledge, emergent TAE has never been performed to address the critical BP fluctuation associated with unruptured PPGL-related hypercatecholaminemic crisis, but we believe its use could rapidly decrease blood flow to the paraganglioma and suppress catecholamine secretion, leading to swift stabilization of BP and symptom relief. Thus, though TAE is theoretically regarded as a potential trigger of hypercatecholaminemic crisis, in this clinical scenario in which other methods are contraindicated, emergent TAE under strict monitoring may represent an important treatment option [28] . Actually, similarly in our patient, this procedure has been described to successfully rescue unruptured PPGL-related catecholamine-induced cardiogenic shock as a bridge to surgical tumor resection [28] .…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Considering these controversies and a lack of consensus in support of this approach for the mediastinal paragangliomas, we believe that an individualized approach is essential. Preoperative embolization may be reserved for highly vascularized and larger mediastinal paragangliomas that have been previously treated with an α-adrenergic blocker and cannot be excised because of hemodynamic instability [ 10 , 11 ].…”
Section: Discussionmentioning
confidence: 99%