[Surgical management of a preaortic paraganglioma: Report of one case]

A retropancreatic celio-mesenteric paraganglioma

Paragangliomas are extra-adrenal pheochromocytomas that arise from chromaffin cells in the sympathetic or parasympathetic neural paraganglia. Surgery remains the only curative treatment, although prominent vascularity can make excision difficult. We have recently encountered a patient with a retropancreatic celio-mesenteric paraganglioma unusually located between celiac trunk (CT) and superior mesenteric artery.

[Retroperitoneal non-secreting paraganglioma: a rare cause of high intestinal occlusion]

Les paragangliomes sont des tumeurs neuroendocrines rares diagnostiquées le plus souvent chez le jeune adulte. Nous rapportons le cas rare d'une jeune femme de 20 ans présentant un paragangliome rétropéritonéal situé sur la face antérolatérale de l'aorte et comprimant l'angle duodéno-jéjunal responsable d'un syndrome subocclusif haut. Dans les formes non sécrétantes, la symptomatologie est souvent déroutante. Le diagnostic n'est généralement fait qu'après examen histologique de la pièce de résection. Le traitement de choix repose sur une chirurgie carcinologique intégrant une concertation multidisciplinaire.

[Management of a retroperitoneal paraganglioma]

Paragangliomas are rare tumors arising from extraadrenal chromaffin cells. We report a 43-year-old man who presented with abdominal pain. An abdominal computed tomography scan revealed a large retroperitoneal mass. During an endoscopic biopsy of this tumor, the patient experienced marked hemodynamic fluctuations with tachycardia and high blood pressure, and an extraadrenal pheochromocytoma was suspected. Measurements of plasma and urinary catecholamines and urinary total metanephrines ruled in the diagnosis. Echocardiography disclosed acute myocardial dysfunction that returned to normal after surgical resection of the paraganglioma. This report also underlines the importance of the anesthetic preparation and monitoring around the surgical procedure and the need of a long-term follow-up to detect malignant paraganglioma in the absence of histological criteria of benign tumor.