A Rare Case of Malignant Peri-Aortic Paraganglioma

Malignancy is rare and the majority of lesions are benign.1 Here we present the case of a 46-year-old male who presented to the ED complaining of nausea, vomiting, left lower quadrant pain, headaches and hypertension that initially was refractory to medications. Adjuvant chemotherapy using cyclophos...

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Bibliographic Details
Published in:The American surgeon 2019-08, Vol.85 (8), p.370-371
Main Authors: Fancher, Crystal, Bridges, Lindsey, Conforti, Arnold
Format: Article
Language:English
Subjects:
Abdomen
Aorta
Carotid body
Catecholamine
Catecholamines
Chemotherapy
Cyclophosphamide
Dacarbazine
Disease control
Epidemiology
Headache
Hypertension
Lymphatic system
Malignancy
Metastases
Metastasis
Nausea
Neuroendocrine tumors
Octreotide
Pain
Paraganglioma
Patients
Radiation
Radioisotopes
Signs and symptoms
Vincristine
Vomiting
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Summary:Malignancy is rare and the majority of lesions are benign.1 Here we present the case of a 46-year-old male who presented to the ED complaining of nausea, vomiting, left lower quadrant pain, headaches and hypertension that initially was refractory to medications. Adjuvant chemotherapy using cyclophosphamide, vincristine, and dacarbazine has shown the most benefit, with 37 per cent tumor burden reduction and 40 per cent having resolution of catecholamine symptoms.2 External beam radiation is showing promise for slowing progression of surgically unresectable disease with 81 per cent of patients showing radiographic local control and 94 per cent being symptom free at five-year follow up.3 Lastly, for extensive metastatic disease, long term radionuclide 131-I metaiodobenzylguanidine (MIBG) therapy may be useful in stabilizing progression of disease in approximately 72 per cent of patients.4, 5 This is primarily being used as a palliative measure. Catecholaminesecreting carotid body paraganglioma: successful preoperative control of hypertension and clinical symptoms using high-dose long-acting octreotide.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481908500801