Incidental functional paraganglioma of the celiac space discovered during breast cancer staging: a case report

Paragangliomas are rare neuroendocrine tumors arising from extra-adrenal chromaffin cells. Although often silent, functional paragangliomas may present with catecholamine hypersecretion and life-threatening complications. Their incidental discovery during cancer staging is exceptionally uncommon and poses unique therapeutic challenges. We report the case of an 82-year-old woman presenting with breast cancer, in whom staging investigations revealed a 6-cm functional paraganglioma of the celiac space. A multidisciplinary team prioritized paraganglioma resection before oncologic breast surgery. Preoperative alpha-adrenergic blockade was administered for 15 days. Surgery was complicated by catecholamine surges requiring intensive hemodynamic and critical care support. Postoperative recovery was uneventful. Histopathological analysis confirmed paraganglioma, and the patient was subsequently referred back for breast surgery. This case illustrates the rare incidental discovery of a hormonally active celiac paraganglioma during breast cancer staging. It highlights the need for multidisciplinary planning and emphasizes the role of perioperative critical care in optimizing outcomes of functional paragangliomas.