October - December 2013, Volume 9, Issue 4

Harza MC, Preda AT, Ismail G, Voinea S, Dudu CE, Baston C, Olaru V, Badescu B, Vladutescu CM, Lupescu I, Hortopan M, Sinescu I

Challenges and Limits in Paraganglioma

Acta Endo (Buc) 2013, 9 (4): 613-621
doi: 10.4183/aeb.2013.613

Background. Paraganglioma develop from embryological neural crest cells from the base of the skull, mediastinum, retroperitoneum, urinary bladder and scrotum. The most common location of the retroperitoneal form is situated between the aorta and vena cava, at the level of left renal vein, or more distally, to the aortic bifurcation. The care of patients with paraganglioma is a challenge for many physicians and surgeons because of its clinical features and therapeutic implications. Case presentation. We report the case of a 22-years old female patient with symptomatic retroperitoneal paraganglioma who was successfully treated with complete surgical excision. The pathological report confirmed the presence of chromaffin tumours. Postoperative care was uneventful, the patient being discharged after 10 days. Follow-up evaluation showed no recurrence after 4 years. Conclusion. Although a very rare condition, retroperitoneal paraganglioma has to be considered in the differential diagnosis of retroperitoneal tumours. Complete surgical resection is crucial for treatment and histological assessment as these tumours are potentially curable if they are diagnosed correctly. In our experience, the best surgical approach is open surgical excision for large masses located in the interaortocaval region, with a clear operatory field and good control over the major blood vessels. Follow-up is strongly recommended.

Keywords: retroperitoneal paraganglioma, surgical excision, metanephrine, catecholamine, arterial hypertension.

Correspondence: Mihai Cristian Harza MD, Fundeni Clinical Institute, Center of Uronephrology and Renal Transplantation, 258 Fundeni Street, District 2, 022328, Bucharest, Romania, E-mail: mihai.harza@gmail.com