VOLUME 30 - NUMBER 51 - 2009

Paragangliomi non secernenti retroperitoneali: due casi clinici

  • Lombardi M., Apa D., Puce E., Senni G.A., Brassetti B.C., Thau A.
  • Articolo Originale, 143-145
  • Full text PDF

  • Non-functional retroperitoneal paragangliom is a rare tumour. They are usully asymptomatic until attainning a remarkable size and discovered incidentally. We present two clinical cases.

    Case 1 A 54 year old man with right abdominal pain referred to our department. Blood pressure and others parameters were normal. Abdominal CT scan and RM revealed a ring-enhanced retroperitoneal encapsulated mass 4x3 cm in diameter located between the inferior vena cava (IVC) and aorta compressing the IVC. Total laparoscopic resection of the tumour was performed without complications. The istology revealeded an extra-adrenal paraganglioma. Immunohistochemically, tumor cells were positive for neuron specific enolase (NSE), synaptophysin, chromogranin A and S100 protein. The patient is desease-free after one year.

    Case 2 A retroperitoneal rigth, hypervascularized mass of 7x5 cm in diameter was found incidentally in a 74-year-old asymptomatic man during a screening echography. CT and MR imaging confirmed a homogeneous, encapsulated mass of about 10 cm in size, with necrotic central area, located between the right renal vein and the IVC deplacing frontally the duodenum. Echoendoscopy with fine needle biopsy of the mass was done without diagnosis. Total resection of the mass was performed through a transabdominal approach. It was diagnosed an extra-adrenal paraganglioma with low grade. Immunohistochemically was similar to other case. Any recurrence was found after 6 months. We can recommend laparoscopic exploration for suspected extraadrenal mass to identify extension of the disease and estimate resectability and to perform a radical surgery.

  • KEY WORDS: paraganglioma, incidental, surgery, laparoscopy.