Krishnamurthy Shalini Shree, Moorthy Saravanan, Muralidharan Krishna, Raja Anand
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India.
Department of Vascular Surgery, Tamil Nadu Government Multi Super Speciality Hospital, Chennai, India.
Vasc Specialist Int. 2025 Mar 4;41:3. doi: 10.5758/vsi.240099.
Paragangliomas are rare neuroendocrine tumors that frequently arise in the organ of Zuckerkandl (OZ). Surgical resection remains the cornerstone of treatment. Although vascular resection and reconstruction have been reported in a few cases, no prior reports have documented the simultaneous resection of both the aorta and inferior vena cava (IVC), along with their bifurcation. We present the case of a 50-year-old man with a large paraganglioma of the OZ, successfully managed through combined resection of the aorta, IVC, their bifurcation, and the psoas muscle. Dacron Y-grafts were used to reconstruct both the aorta and IVC. This case underscores the importance of detailed anatomical knowledge of major vessels, meticulous vascular control, and the technical intricacies of vascular reconstruction. We emphasize the significance of comprehensive perioperative management and provide a literature review on en bloc vascular resection for paraganglioma, offering insights into current surgical practices and outcomes.
副神经节瘤是一种罕见的神经内分泌肿瘤，常发生于主动脉体（OZ）。手术切除仍然是治疗的基石。尽管少数病例报告了血管切除和重建，但此前尚无同时切除主动脉和下腔静脉（IVC）及其分叉的相关报道。我们报告了一例50岁男性患者，患有巨大的主动脉体副神经节瘤，通过联合切除主动脉、下腔静脉、它们的分叉以及腰大肌成功治疗。采用涤纶Y型移植物重建主动脉和下腔静脉。该病例强调了对主要血管详细解剖知识、细致的血管控制以及血管重建技术复杂性的重要性。我们强调了全面围手术期管理的重要性，并提供了关于副神经节瘤整块血管切除的文献综述，以深入了解当前的手术实践和结果。
