Retroperitoneoscopic resection of a primary retroperitoneal paraganglioma occurring between the aorta and vena cava: A case report

A 67-year-old man presented with lower limb weakness, palpitations, and insomnia. His urinary total metanephrine and normetanephrine levels were high. Computed tomography showed a 48 × 34-mm oval mass on the dorsal side of the pancreas and portal vein between the aorta and vena cava. Because of the tumor location, we performed laparoscopic surgery using a retroperitoneal approach. We described a case of a patient with primary retroperitoneal paraganglioma between the aorta and vena cava who underwent retroperitoneoscopic resection. Our case suggests that this procedure can be safely performed.

A case of robot‐assisted adrenalectomy performed for an adrenal tumor (anastomosing hemangioma) exceeding 7 cm

Introduction

Anastomosing hemangioma in the adrenal area is extremely rare. We report a large anastomosing hemangioma in the adrenal area that underwent robot‐assisted adrenalectomy.

Case presentation

A 49‐year‐old man with left back pain underwent magnetic resonance imaging (MRI) that revealed a tumor in the left adrenal area; it was diagnosed as nonfunctional endocrinologically. However, the major axis of the tumor increased from 64 to 72 mm during the 4‐month period. Robot‐assisted left adrenalectomy was performed. Although the large tumor adhered to the surrounding tissues, it was safely resected by the effective use of an extra robotic arm. An anastomosing hemangioma was diagnosed since there were no malignant findings.

Conclusion

Robotic surgical systems may serve as an effective treatment option for large adrenal tumors, and our report is the first robot‐assisted adrenalectomy performed on an anastomosing hemangioma.

Two cases of pelvic schwannomas simultaneously resected with the prostate by robot-assisted surgery

INTRODUCTION

Schwannoma is a rare benign tumor of peripheral nerves arising from Schwann cells of the ubiquitous nerve sheath. The operative steps and technical aspects of robotic resection of pelvic schwannoma are described herein.

CASE PRESENTATION

We describe two patients with pelvic tumors simultaneously resected with the prostate by robot-assisted surgery: a 69-year-old man with schwannoma of the right side of the pelvic floor and a 68-year-old man with schwannoma in the left pelvis. As metastasis of prostate cancer could not be ruled out, tumorectomy was performed using robotic-associated prostatectomy. Malignancy was absent in the two pelvic tumors, and the patients were diagnosed with schwannoma.

CONCLUSION

For surgery in a narrow deep pelvis, robot-assisted surgery is minimally invasive, offers excellent mobility of robotic instruments and visibility of three-dimensional view, and is a useful approach.