Hormone-Negative Retroperitoneal Extra-Adrenal Paraganglioma

Yıl 2022, Cilt: 4 Sayı: 1, 34 - 38, 27.02.2022

Tolga Kalaycı , Deniz Öcal

https://doi.org/10.52827/hititmedj.956812

Öz

Paragangliomas are rare neuroectodermal tumors originating from the parasympathetic nervous system. In this case report, a case of hormone-negative extra-adrenal paraganglioma located retroperitoneally is presented. A 50-year-old female patient was admitted to our clinic with right flank pain. No pathology including urine and blood catecholamine degradation products was detected in the laboratory examinations of the patient. Computed tomography revealed an iso-hypodense solid lesion of 80x50 mm in size, compressing the inferior vena cava and close to the lower part of the pancreas. Surgery was planned for mass resection. During dissection, a severe hypertensive attack occurred, which was controlled with phentolamine. After removal of the mass, blood pressure remained within normal limits in the intraoperative and postoperative periods. The patient was discharged without complications on the 5th postoperative day.

Anahtar Kelimeler

Phentolamine, Hypertensive attack, Hormone-negative, Paraganglioma.

Hormon-Negatif Retroperitoneal Ekstra-Adrenal Paraganglioma

Öz

Paragangliomalar, parasempatik sinir sisteminden kaynaklanan nadir görülen nöroektodermal tümörlerdir. Bu olgu sunumunda retroperitoneal yerleşimli bir hormon negatif ekstra-adrenal paraganglioma olgusu sunulmaktadır. 50 yaşında kadın hasta sağ yan ağrısı ile kliniğimize başvurdu. Hastanın laboratuvar incelemelerinde idrar ve kan katekolamin yıkım ürünleri dahil patoloji saptanmadı. Bilgisayarlı tomografide vena kava inferiora bası yapan ve pankreasın alt kısmına yakın 80x50 mm boyutlarında izo-hipodens solid lezyon saptandı. Kitle rezeksiyonu için cerrahi planlandı. Diseksiyonu sırasında fentolamin ile kontrol altına alınan ciddi bir hipertansif atak meydana geldi. Kitlenin çıkarılmasından sonra intraoperatif ve postoperatif dönemde kan basıncı normal sınırlarda seyretti. Hasta postoperatif 5. günde komplikasyonsuz olarak taburcu edildi.

Anahtar Kelimeler

Fentolamin, Hipertansif atak, Hormon-negatif, Paraganglioma

Kaynakça

• 1. Cunningham SC, Suh HS, Winter JM, Montgomery E, Schulick RD, Cameron JL et al. Retroperitoneal paraganglioma: singleinstitution experience and review of the literature. Journal of Gastrointestinal Surgery 2006;10:1156-1163.
• 2. Elder EE, Elder G, Larsson C. Pheochromocytoma and functional paraganglioma syndrome: no longer the 10% tumor. Journal of Surgical Oncology 2005;89:193-201.
• 3. Rha SE, Byun JY, Jung SE, Chun HJ, Lee HG, Lee JM. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 2003;23:29-43.
• 4. Nishino M, Hayakawa K, Minami M, Yamamoto A, Ueda H, Takasu K. Primary retroperitoneal neoplasms: CT and MR imaging findings with anatomic and pathologic diagnostic clues. Radiographics 2003;23:45-57.
• 5. Chaudhari A, Desai PD, Vadel MK, Kaptan K. Evaluation of primary retroperitoneal masses by computed tomography scan. Int J Med Sci Public Health 2016;5:1423-1429.
• 6. Arda I, Fırat D, Korkmaz S, Demiryılmaz İ, Yılmaz İ. Atipik Prezente Kist Hidatik: Pankreas Başında Kitle. Sakarya Tıp Dergisi 2018;8:149-152.
• 7. Lightfoot N, Santos P, Nikfarjam M. Paraganglioma mimicking a pancreatic neoplasm. JOP Journal of the Pancreas 2011;12: 259-261.
• 8. Türkyılmaz A, Yener Aydın, Kurt A, Dostbil A, Eroğlu A. Paragangliomada Geç Pulmoner Metastaz. The Eurosian Journal of Medi-cine 2007;39:78-80.
• 9. Parithivel VS, Niazi M, Malhotra AK, Swaminathan K. Paraganglioma of the pancreas: literature review and case report. Digestive Diseases and Sciences 2000;45:438-441.
• 10. Sangster G, Do D, Previgliano C, Li B, LaFrance D, Heldmann M. Primary retroperitoneal paraganglioma simulating a pancreatic mass: A case report and review of the literature. HPB Surgery 2010; 645728.
• 11. Adas M, Koc B, Adas G, Yalcin O, Celik S, Kemik Ö. Pitfalls in the diagnosis of pheochromocytoma: A case series and review of the literature. Journal of Epidemiological Research 2015;2:49-55.
• 12. Yang JH, Bae SJ, Park S, Park H-K, Jung HS, Chung JH et al. Bilateral pheochromocytoma associated with paraganglioma and papillary thyroid carcinoma: Report of an unusual case. Endocr J 2007;54:227-231.
• 13. Çelik S, Demir Ö, Tuna B, Yörükoğlu K, Esen A. Retroperitoneal Paraganglioma: Olgu Sunumu. Bulletin of Urooncology 2014; 13:184-186.
• 14. Nap R, Meinardi J, Van Den Berg G, Dullaart R, de Vries J, Wolffenbuttel B. Long-term follow-up is indicated after surgery for a haeochromocytoma. Nederlands Tijdschrift Voor Geneeskunde. 2006;150:1045-1049.