Mesenteric Paraganglioma: An Unusual Suspect To Consider

Mesenteric paragangliomas (PGLs) are extremely rare, with a limited number of reported cases. These tumors are typically non-functioning and commonly manifest as a palpable abdominal mass or abdominal pain; however, a significant proportion of patients remain asymptomatic. Despite their rarity, they should be considered in the differential diagnosis of mesenteric masses. Surgical treatment is the preferred approach, and even after successful complete resection, long-term follow-up is crucial due to the unpredictable potential for metastasis. In this report, we describe the case of a 48-year-old male patient who presented with a self-limited episode of severe abdominal pain, without hyperfunctioning symptoms. The physical examination was unremarkable. Imaging studies revealed the presence of a mesenteric mass. The clinical, laboratory, imaging, and biopsy findings were insufficient to differentiate between an epithelial neuroendocrine tumor and a paraganglioma. Following a review by a neuroendocrine multidisciplinary team, surgery was proposed. While the initial suspicion was an epithelial neuroendocrine tumor, the histopathological examination of the surgical specimen was consistent with a PGL. Currently, after two years of follow-up, the patient remains asymptomatic and is undergoing regular clinical monitoring.