Late Local and Distant Recurrence of Apparently Benign Paraganglioma

Paraganglioma-pheochromocytoma (PPGLs) are relatively rare catecholamine-secreting tumors of chromaffin origin. Due to the sympathetic effects of catecholamine excess, their presentation may range from non-specific symptoms to dangerous hypertensive crises. We present the case of a 36-year-old lady...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-10, Vol.14 (10)
Main Authors: Singh, Brijesh K, G A, Toshib, Bhattacharjee, Hemanga K, Parshad, Rajinder, Damle, Nishikant A
Format: Article
Language:English
Subjects:
Abdomen
Adrenal glands
Blood pressure
Case reports
Disease
Endocrinology/Diabetes/Metabolism
General Surgery
Histopathology
Hypertension
Laparotomy
Lungs
Lymphatic system
Magnetic resonance imaging
Medical imaging
Metastasis
Neuroendocrine tumors
Oncology
Patients
Thoracic surgery
Tumors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Paraganglioma-pheochromocytoma (PPGLs) are relatively rare catecholamine-secreting tumors of chromaffin origin. Due to the sympathetic effects of catecholamine excess, their presentation may range from non-specific symptoms to dangerous hypertensive crises. We present the case of a 36-year-old lady with recurrent paraganglioma (PGL) who presented in emergency with hypertensive crisis. She had a history of surgery for left-sided PGL 18 years earlier. Imaging showed local recurrence with pulmonary metastases and blood biochemistry showed raised urinary metanephrines. In view of her poor general condition, we undertook a staged surgical approach for management. She first underwent en-bloc excision of recurrent PGL with left nephrectomy. Nine weeks later, she underwent a pulmonary metastasectomy. This staged surgical approach resulted in the stabilization of blood pressure and normalization of urinary catecholamine. Although most of these tumors are indolent by nature, this case highlights the metastatic potential of apparently benign PGL. This case explores the possibility of a staged surgical approach in a high-risk patient and emphasizes the need for long-term follow-up in these cases.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.29874