Manière-Constantin D, Bachet P, Chevallier M, Ferrini M, Kepenekian G, Lapras C, Pelegrin-Mollard I
Service de médecine interne, centre hospitalier Saint-Joseph et Saint-Luc, Lyon.
Arch Mal Coeur Vaiss. 1997 Aug;90(8):1185-8.
A 53 years old man had an angiography for suspected renovascular hypertension (arteritis, renal insufficiency, duplex scanning). It showed a narrow right renal artery streched by a 45 mm mass arising from the adrenal. The computed tomography showed the tumor and the nuclear magnetic resonance imaging indicated a pheochromocytoma. The patient had no complain of headaches, palpitations or sweating. Biochemistry was normal except for a slight serum creatinin elevation and a non significant urinary noradrenaline level. A diagnostic of non functioning pheochromocytoma was made. The therapeutics consisted in a surgical ablation of the tumor and the right kidney (non functioning) and the patient became normotensive thereafter without treatment. The histologic feature was an aortico-sympathetic paraganglia, the adrenal was normal. Paraganglias are arising from the paraganglion system including chemodectoma and glomus jugulare tumor. Non functioning retroperitoneal paraganglias are uncommon: less than 50 in the literature between 1902 and 1992.
一名53岁男性因疑似肾血管性高血压(动脉炎、肾功能不全、双功超声扫描)接受了血管造影。造影显示右肾动脉狭窄,被一个起源于肾上腺的45毫米肿块牵拉。计算机断层扫描显示了肿瘤,核磁共振成像提示为嗜铬细胞瘤。患者无头痛、心悸或出汗症状。除血清肌酐略有升高和尿去甲肾上腺素水平无显著异常外,生化检查正常。诊断为无功能嗜铬细胞瘤。治疗方法为手术切除肿瘤及右侧无功能肾脏,此后患者未经治疗血压恢复正常。组织学特征为主动脉交感神经节旁体,肾上腺正常。神经节旁体起源于神经节旁系统,包括化学感受器瘤和颈静脉球瘤。无功能的腹膜后神经节旁体并不常见:1902年至1992年间文献报道不足50例。