I-MIBG ON DIAGNOSTIC AND THERAPEUTIC FRONTIERS IN EXTRA-ADRENAL ABDOMINAL PARAGANGLIOMAS: A CASE REPORT WITH MINI REVIEW A L O F RA D IO L O GY Case Report (original) (raw)
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2014
metastases. After 3 days a whole body radionuclide bone scan (Techentium-99m Methylene Diphosphonate) was performed which revealed multiple bony metastases with lateral displacement of left kidney due to clinically known retroperitoneal mass (Fig. 3). A CT guided core biopsy of left sided abdominal mass was done and histopathology revealed paraganglioma. His vanillylmandelic acid level was raised (30 mg; Normal <13.6 mg). He underwent an exploratory laparatomy and retroperitoneal mass was resected with left kidney. Histopathology revealed paraganglioma (Ki-67 proliferative index 15-20%) and no evidence of tumor invasion to left kidney. 131I-MIBG ON DIAGNOSTIC AND THERAPEUTIC FRONTIERS IN EXTRA-ADRENAL ABDOMINAL PARAGANGLIOMAS: A CASE REPORT WITH MINI REVIEW
Pjr, 2013
There was no evidence of pulmonary or liver metastases. After 3 days a whole body radionuclide bone scan (Techentium-99m Methylene Diphosphonate) was performed which revealed multiple bony metastases with lateral displacement of left kidney due to clinically known retroperitoneal mass (Fig. 3). A CT guided core biopsy of left sided abdominal mass was done and histopathology revealed paraganglioma. His vanillylmandelic acid level was raised (30 mg; Normal <13.6 mg). He underwent an exploratory laparatomy and retroperitoneal mass was resected with left kidney. Histopathology revealed paraganglioma (Ki-67 proliferative index 15-20%) and no evidence of tumor invasion to left kidney.
An unusual localization of retroperitoneal paraganglioma: a case report
Pan African Medical Journal, 2015
Paragangliomas are rare tumors arising from extra-adrenal chromaffine tissues. The diagnosis of non-functional retroperitoneal paraganglioma and its surgical management can be difficult. We report a case of a retroperitoneal paragangliomaof an unusual localization that renders the surgery more challenging. A 40 year-old woman presented to our department with a four-month history of upper quadrant pain with no vomiting, no fever, nor jaundice. Physical examination was normal. Ultrasonography showed a retro duodenal homogenous mass and computed tomographyscan showed a well-circumscribed round mass of heterogeneous density, which was in close contact with the aorta and the left kidney vein. Laboratory tests were normal. The patient underwent surgical management. The surgical exploration found a retroperitoneal tumor that was encapsulated and showing intimate contact with the abdominal aorta. We performed a complete resection of the tumor. Histological examination of the surgical specimen revealed a paraganglioma. The post operative course was uneventful. Paragangliomas are rare tumors. They can be asymptomatic for a long time and thus be diagnosed at late stage. A follow-up of patients is then essential. Surgical treatment is the only radical treatment and should be performed even in paragangliomas in close contact with the great vessels.
Extraadrenal retroperitoneal paraganglioma: clinical, pathologic, and CT findings
American Journal of Roentgenology, 1990
Paragangliomas of the retroperitoneum arise from specialized neural crest cells distributed along the aorta in association with the sympathetic chain. In order to ascertain characteristic CT features of extraadrenal retroperitoneal paragangliomas to differentiate them from other retroperitoneal tumors, 31 discrete tumors and two cases of paragangliomatosis in 28 patients were reviewed retrospectively, and the CT features were correlated with clinical and pathologic findings. There were 16 men and 12 women. Average age was 37 years (range, 11-70 years). Twenty-four patients (86%) had hypertension. Of these, catecholamine levels were elevated in all 18 patients who had biochemical studies. Four patients (14%) had malignant paragangliomas. with continuous paraaortic tumors. These cases were accessioned into the archives of the Department of Radiologic Pathology at the Armed Forces Institute of Pathology between
Retroperitoneal Paraganglioma: A Case Report
Background: Retroperitoneal paraganglioma is a rare tumor that develops from chromaffin cells that secrete catecholamines in the sympathetic ganglia. Universally known as pheochromocytoma, tumors located outside the adrenal gland have been designated as extraadrenal paragangliomas. Aim of the work: The authors report the case of a retroperitoneal paraganglioma with analysis of clinical and imaging features and review of the relevant literature. Case report: We report the case of 84-year-old woman with medical history of hypertension and who was complaining of vomiting and pain in the epigastrum and upper right quadrant. Physical examination and laboratory tests revealed no abnormalities. Ultrasound sonography and abdominal CT-scan showed a round well limited retroperitoneal lesion of c. 7 cm composed of cysts and plain tissue adjacent to the tail of the pancreas, the posterior surface of the stomach and the left renal vein. The Magnetic resonance Imaging (MRI) showed a lesion that was hypointense on T1 and heterogeneous hyperintense on T2. The preoperative diagnosis was tumor of the tail of the pancreas or the gastrointestinal stromal tumor (GIST) or the extra digestive stromal tumor (E-GIST). The patient was operated on via a midline incision. We had found a lesion-that was deeply embedded in the left transverse mesocolon near the duodeno-jejunal flexure. It was well encapsulated, surrounded by several peri-capsular veins having connection with the inferior mesenteric vein and the left renal vein. A complete tumor resection was performed.. The histopathological diagnosis was retroperitoneal paraganglioma without any signs of malignancy. Conclusion: When confronted to a posterior abdominal mass, the first step is to be sure of its retroperitoneal origin. Then, the second step is to try to guess its nature and characterize it. When symptoms and signs are not clear, it is essential to know their most frequent location, in order to think of the diagnosis of paraganglioma. Surgery is the main treatment because of their malignant potential. The removal must be complete to be curative.
Pan African Medical Journal, 2017
Paragangliomas are benign neoplasms that arise from the autonomic nervous system and the associated paraganglia. Although benign, they have been shown to possess metastatic potential. Extra-adrenal retroperitoneal paraganglioma with vertebral metastasis is considered very uncommon. Here, we present a case of a functional extra-adrenal paraganglioma of the retroperitoneum giving metastasis to T4 vertebra after five years of follow-up in a 48-year-old man who had been initially treated with complete resection of the primary tumor. The condition of the patient improved significantly after radiosurgery and somatostatin analogs treatment, until lumbar spine lesions appeared six months later. Our case demonstrates that retroperitoneal paraganglioma is a rare condition which should be considered in the differential diagnosis of a retroperitoneal mass combined with vertebral lesions. Additionally, increased physician awareness and long-term follow-up is mandatory for all patients with history of retroperitoneal paraganglioma since metastases may occur after long latent intervals from the initial diagnosis.
Retroperitoneal paraganglioma: clinical presentation and treatment outcomes in two patients
Introduction: Paragangliomas are rare neuroendocrine tumors that arise from extra-adrenal autonomic ganglia. The aim of this paper is to analyze the presentation, diagnosis and treatment outcomes of two patients with retroperitoneal paraganglioma treated in our hospital. Case Presentation: The first case is a 34 year old female, ASA status 1, who underwent elective surgery for removal of retroperitoneal tumor. Laparoscopic surgical resection was decided. Minimal tumor manipulation was followed with severe hypertension. Due to high suspicion of the presence of a catecholamine-secreting tumor, intravenous antihypertensive drugs were given. The patient coursed with hypotension and acute pulmonary edema after the surgery. Transthoracic echocardiogram showed apical ballooning with impaired ejection fraction of the left ventricle. After 3 days in Cardiac Care Unit the patient was discharged. The second case is a 25 years old male, with large history of refractory hypertension who was admi...
Retroperitoneal Paraganglioma: Single-Institution Experience and Review of the Literature
Journal of Gastrointestinal Surgery, 2006
Paragangliomas are rare tumors arising from extra-adrenal chromaffin cells. We examined the clinical characteristics of all patients at our institution having paragangliomas resected from 1984 through 2005. Of 253 resections, 22 (9%) were retroperitoneal and were selected for further study. The ratio of males to females was 1.3:1, and the median age was 39 years. The average size, rate of metastasis (i.e., malignancy), and rate of function was 7.4 cm, 9.5%, and 57.1%, respectively. Tumors larger than 7 cm were more likely to require adjacent organ resection (P 5 0.01). The overall 5-year survival was 73%. Survival was significantly worse after metastasis (P 5 0.0023) but did not depend on the tumor diameter, the secreting function of the tumor, the status of surgical margins of resection, or status of the resected lymph nodes.