Extra-Adrenal Silent Paraganglioma: An Old Foe

Dibesh Shrestha, Wen-Liang Li, Jian Huang, Zhu Zhu, Rui-Ze Zhou and Quan Yang

Department of Surgical Oncology, First Affiliated Hospital of Kunming Medical University, China

^*Correspondance to: Wen-Liang Li 

 PDF  Full Text DOI: 10.25107/2474-1647.2249

Abstract

Extra-adrenal paragangliomas are rare neuroendocrine tumors arising from chromaffin cells located in areas where par ganglia normally occur. They usually present with symptoms of catecholamine excess, however, a significant proportion of cases are asymptomatic or present with non-specific symptoms. One such variety comprises the silent or normotensive paraganglioma. We present a case of a 50 year-old female who presented with abdominal pain. On Magnetic Resonance Imaging (MRI) a well demarcated mass was found on the posterior abdominal wall, closely related to the abdominal aorta and the left kidney. During surgery to remove the mass, hemodynamic fluctuations were encountered, which were able to be managed promptly. Here we highlight the non-specific presentation of a silent paraganglioma leading to diagnostic dilemma and its potentially catastrophic consequences. We also focus on the lack of specific non-invasive preoperative diagnostic characteristics which are necessary for patient safety and suggest the routine assessment of the much under-utilized catecholamine profile in the preoperative evaluation of lesions localized in the potential sites of occurrence of paragangliomas, especially in patients presenting with non-specific symptoms.

Keywords

Paraganglioma; Pheochromocytoma; Extra-adrenal; Neuroendocrine tumor; Catecholamine; Hypertensive crisis

Cite the article

Shrestha D, Li W-L, Huang J, Zhu Z, Zhou R-Z, Yang Q. Extra-Adrenal Silent Paraganglioma: An Old Foe. Clin Surg. 2018; 3: 2249.