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Updated: May 20, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Diaphoresis and abdominal pain caused by extra-adrenal paragangliomas
Lennard Lee1, Wei Lin Sung, Mohammed Majid Akhtar
1Guy's & St Thomas's NHS Foundation Trust, London, UK.
Abstract:
A 63-year-old lady presented with suprapelvic pain, weight loss and night sweats. On examination, she was noted to be hypertensive with a distended abdomen. Imaging (CT) revealed a 9.5 cm retroperitoneal mass with a high degree of vascularity and necrotic centre. The patient's urinary and plasma catecholamines were significantly raised and subsequent radio-isotope scan suggested the tumour was likely to be of a neuroendocrine nature. A diagnosis of a malignant paraganglioma was made. Malignant paragangliomas derive from sympathetic tissue and secrete catecholamines. Diagnostic uncertainty might lead to biopsy of tumour but this carries a high-risk of catecholamine-induced complications such as hypertensive crisis, cardiac arrhythmias and cardiac ischaemia and must be avoided.
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