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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[Multiple paraganglioma: careful with surgery!]
L Díez Porres1, F García Iglesias, G Pérez Martín
1Servicio de Medicina Interna. Hospital Universitario La Paz. Madrid. Spain. gil@eurosur.com
Revista Clinica Espanola
|October 18, 2003
Summary
Bilateral paragangliomas present surgical challenges and potential for severe morbidity. Postoperative baroreflex dysfunction can cause extreme blood pressure fluctuations, requiring careful diagnosis and management.
Area of Science:
- Neuro-oncology
- Endocrinology
- Vascular Surgery
Background:
- Extraadrenal paragangliomas are rare tumors, often presenting as multiple lesions.
- Surgical treatment for bilateral paragangliomas is controversial due to potential severe morbidity.
Observation:
- A 23-year-old woman underwent surgery for left carotid and right vagal paragangliomas.
- Postoperatively, she experienced cranial nerve deficits and significant blood pressure lability, alternating between severe hypertension and hypotension.
Findings:
- Diagnostic workup, including imaging and biochemical tests, ruled out other pathologies.
- Neurophysiological studies confirmed baroreflex dysfunction and cranial nerve paralysis (IX, X, XII).
Implications:
- This case highlights the complexities in managing bilateral paragangliomas and associated surgical risks.
- Baroreflex dysfunction must be considered in the differential diagnosis of patients with extreme blood pressure variability.
