Large functional retroperitoneal paraganglioma: A surgical challenge

Area of Science:

• Oncology
• Surgical Oncology
• Endocrinology

Background:

• Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of the sympathetic nervous system.
• Retroperitoneal paragangliomas, particularly functional ones, pose significant diagnostic and surgical challenges.
• Misdiagnosis of functional paragangliomas can lead to severe intraoperative hypertensive crises due to catecholamine release.

Observation:

• A 40-year-old female presented with a large, functional, right-sided retroperitoneal paraganglioma.
• The tumor extensively encased the inferior vena cava (IVC), complicating surgical planning.
• The patient's presentation necessitated a complex surgical approach.

Findings:

• The patient underwent successful excision of the paraganglioma.
• The surgical procedure included resection of the inferior vena cava (IVC) and a right nephrectomy.
• This complex multivisceral resection was performed successfully.

Implications:

• Complex retroperitoneal surgeries, including those involving major vascular structures like the IVC, demand specialized surgical expertise.
• High-volume centers with extensive experience in retroperitoneal and oncologic surgeries are crucial for managing such challenging cases.
• Successful management underscores the feasibility of aggressive surgical intervention for large, encasing retroperitoneal paragangliomas.