1
|
Ghantous I, Najjar A, Tlaiss Y, Danaf S, Chouairy CJ. Resection of Retroperitoneal Extra-Adrenal Pheochromocytoma: A Case Report. Cureus 2023; 15:e43185. [PMID: 37692674 PMCID: PMC10485873 DOI: 10.7759/cureus.43185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Extra-adrenal pheochromocytomas are rare catecholamine-producing tumors that arise from chromaffin cells outside the adrenal glands. We report on the case of a 62-year-old male who initially presented with upper respiratory tract symptoms and was found to have a suprapubic pelvic mass and an asymptomatic right inguinal hernia. The diagnostic evaluation involved an abdominal ultrasound, a CT scan, followed by an MRI, which revealed a well-marginated large mass whose characteristics indicated a retroperitoneal sarcoma. Upon successful surgical resection, the mass was found to be encapsulated and no peripheral structure invasion was present; the right inguinal hernia was repaired, and a double J-stent was placed. Histopathological examination revealed extra-adrenal pheochromocytoma. This case report sheds light on diagnostic and therapeutic challenges when dealing with extra-adrenal pheochromocytomas and the importance of considering them as a differential diagnosis when presented with a case of retroperitoneal mass.
Collapse
Affiliation(s)
- Imad Ghantous
- Urology, Saint George University Hospital in Beirut, Beirut, LBN
| | - Aziz Najjar
- Urology, Saint George University Hospital in Beirut, Beirut, LBN
| | | | - Samer Danaf
- Urology, University of Balamand, Beirut, LBN
| | - Camil J Chouairy
- Pathology, Saint George University Hospital in Beirut, Beirut, LBN
| |
Collapse
|
2
|
Zhang J, Cao L, Yan L, Jin C, Zhang D. A young patient with heart failure was diagnosed with extra-adrenal paraganglioma: a case report. BMC Cardiovasc Disord 2022; 22:574. [PMID: 36581844 PMCID: PMC9801580 DOI: 10.1186/s12872-022-03026-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We present a case of pelvic paraganglioma that presented with heart failure as the primary symptom. CASE PRESENTATION A 35-year-old man was admitted to hospital due to heart failure. Contrast-enhanced pelvic CT showed mass shadows in the posterior wall of the bladder and multiple enlarged lymph nodes in the retroperitoneal area. Ultrasound-guided puncture was performed, and the pathologic diagnosis was extra-adrenal paraganglioma. The patient refused any chemotherapy and died within six months of diagnosis. CONCLUSION The possibility of neuroendocrine-related tumors, for example paragangliomas, should be considered in young patients with heart failure, especially those with concomitant hypertension and diabetes.
Collapse
Affiliation(s)
- Jing Zhang
- grid.452828.10000 0004 7649 7439Respiratory Department, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning China
| | - Lihua Cao
- grid.452828.10000 0004 7649 7439Respiratory Department, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning China
| | - Lina Yan
- grid.452828.10000 0004 7649 7439Respiratory Department, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning China
| | - Cong Jin
- grid.452828.10000 0004 7649 7439Respiratory Department, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning China
| | - Dan Zhang
- grid.452828.10000 0004 7649 7439Respiratory Department, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, Liaoning China
| |
Collapse
|
3
|
Constantinescu G, Preda C, Constantinescu V, Siepmann T, Bornstein SR, Lenders JWM, Eisenhofer G, Pamporaki C. Silent pheochromocytoma and paraganglioma: Systematic review and proposed definitions for standardized terminology. Front Endocrinol (Lausanne) 2022; 13:1021420. [PMID: 36325453 PMCID: PMC9618947 DOI: 10.3389/fendo.2022.1021420] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors with heterogeneous clinical presentations and potential lethal outcomes. The diagnosis is based on clinical suspicion, biochemical testing, imaging and histopathological confirmation. Increasingly widespread use of imaging studies and surveillance of patients at risk of PPGL due to a hereditary background or a previous tumor is leading to the diagnosis of these tumors at an early stage. This has resulted in an increasing use of the term "silent" PPGL. This term and other variants are now commonly found in the literature without any clear or unified definition. Among the various terms, "clinically silent" is often used to describe the lack of signs and symptoms associated with catecholamine excess. Confusion arises when these and other terms are used to define the tumors according to their ability to synthesize and/or release catecholamines in relation to biochemical test results. In such cases the term "silent" and other variants are often inappropriately and misleadingly used. In the present analysis we provide an overview of the literature and propose standardized terminology in an attempt at harmonization to facilitate scientific communication.
Collapse
Affiliation(s)
- Georgiana Constantinescu
- Department of Endocrinology and Diabetes, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Endocrinology, Grigore T. Popa University, Iasi, Romania
- Department of Health Care Sciences, Center for Clinical Research and Management Education, Dresden Inter-national University, Dresden, Germany
- *Correspondence: Christina Pamporaki, ; Georgiana Constantinescu,
| | - Cristina Preda
- Department of Endocrinology, Grigore T. Popa University, Iasi, Romania
| | - Victor Constantinescu
- Center of Clinical Neuroscience, University Clinic Carl-Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Timo Siepmann
- Department of Health Care Sciences, Center for Clinical Research and Management Education, Dresden Inter-national University, Dresden, Germany
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan R. Bornstein
- Department of Endocrinology and Diabetes, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Jacques W. M. Lenders
- Department of Endocrinology and Diabetes, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Graeme Eisenhofer
- Department of Endocrinology and Diabetes, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University of Dresden, Dresden, Germany
| | - Christina Pamporaki
- Department of Endocrinology and Diabetes, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- *Correspondence: Christina Pamporaki, ; Georgiana Constantinescu,
| |
Collapse
|