Mesenteric Extra-adrenal Paraganglioma - An Unusual Cause of Intermittent Abdominal Pain

Paragangliomas are non-epithelial tumors of neuroendocrine origin that arise from the paraganglia of the sympathetic and parasympathetic nervous system. These paraganglia cells are derived from the neural crest and can be found anywhere in the body where paraganglia exist. Paragangliomas are rare tumors. It is estimated that the incidence of pheochromocytoma (intra-adrenal paraganglioma) and extra-adranal paraganglioma is 0.8 per 100,000 person years. It is commonly stated that 10 percent of paragangliomas are extra-adrenal. The majority of parasymphathetic paragangliomas reside in the skull base and along the vagus and glossopharyngeal nerves, whereas the majority of sympathetic paragangliomas can be found in the abdomen. Paragangliomas found in the mesentery are exceedingly rare, with 12 reported cases identified in the literature. We present the case of a 61-year-old female who presented to our institution with a suspected superior mesenteric artery aneurysm who was ultimately found to have an extra-adrenal paraganglioma within the small bowel mesentery of the right lower quadrant of the abdomen.