[Laparoscopic Tumor Resection for Asymptomatic Paraganglioma-A Case Study]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endocrinology

Background:

• Paragangliomas are rare neuroendocrine tumors arising from extra-adrenal chromaffin cells.
• Abdominal paragangliomas can present as asymptomatic masses, posing diagnostic challenges.
• Early detection and surgical management are crucial for favorable outcomes.

Observation:

• A 55-year-old male presented with an incidentally discovered abdominal mass on ultrasonography.
• Contrast-enhanced CT revealed a 36-mm heterogeneously enhancing mass adjacent to the aorta, originating from the transverse colon mesentery.
• Intraoperative temporary hypertension was noted during laparoscopic tumor resection.

Findings:

• Histopathological examination confirmed a paraganglioma characterized by tumor cells with abundant cytoplasm and sinusoidal vascularization.
• Immunohistochemistry was positive for chromogranin A, synaptophysin, and neural cell adhesion molecule.
• The tumor was successfully resected laparoscopically, with the patient discharged on postoperative day 8.

Implications:

• Laparoscopic resection is a viable and effective minimally invasive approach for asymptomatic abdominal paragangliomas.
• This case underscores the importance of thorough histopathological and immunohistochemical analysis for accurate diagnosis.
• Further research into the optimal management strategies for intraoperative hypertensive events associated with paragangliomas is warranted.