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Related Experiment Video

Updated: Jul 20, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

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
PubMed
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.

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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:

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  • 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.