Retroperitoneal paragangliomas: Report of 4 cases

Abstract

We reviewed the data of all patients managed for retroperitoneal paragangliomas (PGLs) between June 2010 and June 2011 to present our experience concerning this uncommon entity to highlight diagnostic and therapeutic challenges of retroperitoneal PGLs. All patients were admitted to the department of general and hepatobiliary surgery in the regional hospital of Jendouba, Tunisia. The size of the tumor was taken at its largest dimension, as determined in a computed tomography (CT) scan and pathological reports. There were 4 patients (all women) with a median age of 48 years (range 46-56 years). Abdominal pain was the commonest presentation. CT showed and localized the tumors which were all retroperitoneal. All patients had successful surgical resection of the tumors under invasive arterial blood pressure monitoring. One patient underwent surgery for a presumed tumor of the pancreatic head. The fresh-mount microscopic study of the peroperative biopsy yielded inflammatory tissue without malignancy and no resection was performed. Final histological examination of the biopsy concluded PGL. A second laparotomy was performed and the tumor was entirely resected. The diagnosis was made after surgery by histology in all patients. The control of the blood pressure was improved after surgery in 3 patients. Paragangliomas are rare tumors. The retroperitoneal localization is uncommon. Complete surgical resection remains the only curative treatment but it is often challenging as these tumors are located near multiple vital blood vessels.

An incidental finding of retroperitoneal paraganglioma during the coronavirus disease 2019 pandemic: a case report

“…Surgery is the treatment of choice for paraganglioma [8], and it is associated with an improved survival rate, even in patients with distant metastasis. Complete surgical resection remains the only curative treatment but it is challenging, as these tumors are located near multiple vital blood vessels [9]. Before surgery, appropriate medical preparation with α-blocking and β-blocking agents is very crucial to avoid intraoperative hypertensive crisis [10].…”

Gestion péri opératoire d’un paragangliome rétro-péritonéal

“…Les arythmies et l'hypotension peuvent se déclencher après la résection du paraganglionome [ 10 ]. L'hypotension artérielle, voire le collapsus après ablation de la tumeur, doivent être prévenus par l'arrêt anticipé des vasodilatateurs et des bêtabloquants dès la ligature de la veine drainant la tumeur, et l'optimisation du remplissage associé à la noradrénaline, au mieux guidé par le monitorage hémodynamique [ 2 , 6 , 11 ].…”