Shen Meng-Ting, Xuan Ye, Chen Kai-Yu, Lu Xin-Lei, Lei Wei-Ping, Huang Ya-Qin, Sun Jian-Liang
The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, China.
Department of Anesthesiology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, China.
Front Oncol. 2025 Aug 1;15:1614545. doi: 10.3389/fonc.2025.1614545. eCollection 2025.
Retroperitoneal paraganglioma is an extremely rare tumor. Its atypical clinical presentations often lead to missed and misdiagnosis. Here, we report a 60-year-old male with unexplained weight loss and a medical history of hypertension and diabetes. Preoperative evaluations showed a left lower abdominal mass, considered as a malignant gastrointestinal stromal tumor or a leiomyosarcoma. During the laparoscopic resection of tumor, his blood pressure fluctuated significantly, especially with the tumor manipulation that caused hypertensive crisis. Phentolamine infusion was given to control the blood pressure, and the tumor was removed under the open abdominal surgery. Further laboratory tests on catecholamine levels and postoperative histopathology confirmed the diagnosis of retroperitoneal paraganglioma. Follow-up showed good recovery with no complications. Paraganglioma should be considered when an unknown mass with severe blood pressure fluctuations is encountered during surgery. Careful preoperative preparations and close intraoperative monitoring should be applied in patients with suspected paraganglioma.
腹膜后副神经节瘤是一种极其罕见的肿瘤。其非典型的临床表现常导致漏诊和误诊。在此，我们报告一名60岁男性，有不明原因的体重减轻，并有高血压和糖尿病病史。术前评估显示左下腹有一肿块，考虑为恶性胃肠道间质瘤或平滑肌肉瘤。在腹腔镜肿瘤切除术中，他的血压波动显著，尤其是在肿瘤操作时引发了高血压危象。给予酚妥拉明静脉滴注以控制血压，随后在开腹手术下切除肿瘤。进一步的儿茶酚胺水平实验室检测及术后组织病理学检查确诊为腹膜后副神经节瘤。随访显示恢复良好，无并发症。当手术中遇到不明肿块且伴有严重血压波动时，应考虑副神经节瘤。对于疑似副神经节瘤的患者，应进行仔细的术前准备并在术中进行密切监测。
