Yuan Miao, Xu Chang, Yang Gang, Wang Weiya
Department of Pediatric Surgery Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
Medicine (Baltimore). 2018 Jul;97(27):e11212. doi: 10.1097/MD.0000000000011212.
Paraganglioma is rare in children and most pheochromocytomas originate in the adrenal gland.
The clinical characteristics, diagnosis, and managements in a 9-year-old boy who presented with vomiting and occasional headache with a blood pressure of 210/170 mm Hg was retrospectively reviewed. CT scan of the chest revealed a 7 × 5-cm-sized soft tissue mass in the left paraspinal area. Biochemical reports revealed elevated levels of serum norepinephrine, urine norepinephrine, urine dopamine, and serum neuron specific enolase.
The immunohistochemical studies suggested that the tumor was a paraganglioma of the posterior mediastinum.
The patient underwent mass resection with thoracotomy. Before operation, the patient was prepared by orally administering captopril, propranolol hydrochloride, and phenoxybenzamine. Body fluid volume was also prepared by vein and mouth in 3 days.
The patient was followed up postoperatively for 1 year without recurrence.
We should be highly vigilant the pediatric tumor of the posterior mediastinum with vomiting and headache as the first clinical manifestation.
副神经节瘤在儿童中罕见,且大多数嗜铬细胞瘤起源于肾上腺。
回顾性分析一名9岁男孩的临床特征、诊断及治疗过程,该男孩以呕吐和偶发头痛就诊,血压为210/170 mmHg。胸部CT扫描显示左椎旁区域有一个7×5 cm大小的软组织肿块。生化报告显示血清去甲肾上腺素、尿去甲肾上腺素、尿多巴胺和血清神经元特异性烯醇化酶水平升高。
免疫组化研究提示该肿瘤为后纵隔副神经节瘤。
患者接受了开胸肿块切除术。术前,通过口服卡托普利、盐酸普萘洛尔和酚苄明对患者进行准备。在3天内通过静脉和口服补充体液。
患者术后随访1年无复发。
对于以呕吐和头痛为首发临床表现的儿童后纵隔肿瘤,我们应高度警惕。