Takeuchi Kyosuke, Hosoya Kenji, Owaki Ryo, Kinoshita Ryohei, Kim Sangho, Okumura Masahiro
Hokkaido University Veterinary Teaching Hospital, Kita 18 Nishi 9, Kita-ku, Sapporo, Hokkaido, 060-0818, Japan.
Laboratory of Veterinary Surgery, Department of Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Hokkaido, 060-0818, Japan.
BMC Vet Res. 2025 Nov 7;21(1):651. doi: 10.1186/s12917-025-05096-x.
Paraganglioma (PGL) is a general term for tumors that originate in the paraganglia in dogs, most commonly reported in the carotid and aortic bodies. Reports on surgical treatment are rare because these tumors develop near large blood vessels, and their prognosis remains unclear. In dogs, the indications for and safety of surgical procedures involving the celiac artery (CA) root and the dissection of its major branches have not been established. To the best of our knowledge, this is the first reported case of CA root involvement in canine PGL.
Surgery was performed on day 84 to remove a PGL tumor. The mass was firmly attached to the left lobe of the pancreas, portal vein, CA, and cranial mesenteric artery (CMA). Therefore, a combined resection was performed, including the spleen, left lobe of the pancreas, and left hepatic lymph nodes. Among the main branches of the CA, the splenic and left gastric arteries could not be separated and were transected. Consequently, the stomach wall became ischemic, and reduced pulsation of the left gastric and omental arteries was observed. To maintain blood supply, the common hepatic artery was preserved. After normalization of the stomach wall color, the CMA was separated from the mass, and the tumor was removed. Pathological examination confirmed that the mass was a PGL, with no metastasis to the hepatic lymph nodes. A computed tomography scan on day 265 revealed that blood flow in the common hepatic artery, portal vein, and left gastric region was well maintained. As of day 279, there was no evidence of metastasis or recurrence, and the patient remained in good condition.
In this case, the main branches of the CA, except for the common hepatic artery, were transected to remove the mass; however, the patient was discharged without serious complications. This is attributable to recovery of blood flow from collateral routes. Considering this blood flow recovery and that intraoperative gastric ischemia was temporary, complete ligation of the CA root may be acceptable in some cases. Additionally, the prognosis for PGL was favorable when complete resection was achieved.
副神经节瘤（PGL）是起源于犬类副神经节的肿瘤的统称，最常见于颈动脉体和主动脉体。关于手术治疗的报道很少，因为这些肿瘤在大血管附近生长，其预后仍不明确。在犬类中，涉及腹腔动脉（CA）根部及其主要分支解剖的手术指征和安全性尚未确定。据我们所知，这是首例报道的犬类PGL累及CA根部的病例。
在第84天进行手术切除PGL肿瘤。肿块与胰腺左叶、门静脉、CA和肠系膜上动脉（CMA）紧密相连。因此，进行了联合切除，包括脾脏、胰腺左叶和左肝淋巴结。在CA的主要分支中，脾动脉和胃左动脉无法分离，予以切断。结果，胃壁出现缺血，观察到胃左动脉和网膜动脉搏动减弱。为维持血供，保留了肝总动脉。胃壁颜色恢复正常后，将CMA与肿块分离，切除肿瘤。病理检查证实肿块为PGL，无肝淋巴结转移。第265天的计算机断层扫描显示，肝总动脉、门静脉和胃左区域的血流保持良好。截至第279天，没有转移或复发的迹象，患者状况良好。
在本病例中，为切除肿块切断了CA的主要分支（肝总动脉除外）；然而，患者出院时没有严重并发症。这归因于侧支循环血流的恢复。考虑到这种血流恢复以及术中胃缺血是暂时的，在某些情况下完全结扎CA根部可能是可以接受的。此外，当实现完全切除时，PGL的预后良好。
