Feng YF, Pan YF, Zhou HL, Hu ZH, Wang JJ, Chen B. Surgical resection of a recurrent retroperitoneal paraganglioma: A case report. World J Clin Oncol 2025; 16(3): 101240 [DOI: 10.5306/wjco.v16.i3.101240]
Corresponding Author of This Article
Bing Chen, MD, Department of Vascular Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 2114008@zju.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yan-Fei Feng, Yi-Feng Pan, Han-Lei Zhou, Zhao-Hua Hu, Jue-Jue Wang, Bing Chen, Department of Vascular Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Feng YF and Pan YF contributed to manuscript writing and editing; Zhou HL contributed to data collection; Hu ZH and Wang JJ contributed to data analysis; Chen B contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported by Natural Science Foundation of Zhejiang Province, China, No. LQ21H020007.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bing Chen, MD, Department of Vascular Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 2114008@zju.edu.cn
Received: September 8, 2024 Revised: December 19, 2024 Accepted: January 2, 2025 Published online: March 24, 2025 Processing time: 134 Days and 17.2 Hours
Abstract
BACKGROUND
Paraganglioma (PGL) is a neuroendocrine tumor originating from paraganglia that can occur in various locations, such as the head, neck, chest, abdomen, and pelvis. Retroperitoneal PGLs are rare, and recurrent cases in this area are particularly uncommon, posing considerable surgical complexities. Owing to their neuroendocrine activity, PGLs are capable of secreting hormones like catecholamines, thereby presenting significant challenges in hemodynamic management during the perioperative period.
CASE SUMMARY
We report a 64-year-old man with a recurrent retroperitoneal PGL. The patient underwent retroperitoneal mass resection in 2013, with postoperative pathology revealing a PGL. Regular follow-up was not conducted until April 2024, when a computed tomography scan revealed a huge mass in the retroperitoneum, closely adjacent to the abdominal aorta. Laboratory examinations revealed elevated levels of catecholamines in the patient's blood serum. Upon admission, volume expansion and blood pressure (BP) monitoring were carried out for one week, with catecholamine levels reviewed and normalized. Adequate preoperative preparation was conducted, including central venous access, arterial BP monitoring, and the preparation of vasoactive agents. During tumor resection, the patient experienced acute, significant fluctuations in BP. The timely intervention of the anesthesiologist stabilized the BP, facilitating the successful resection of the tumor which was confirmed as a recurrent PGL. Postoperative follow-up revealed no evidence of tumor residual or recurrence.
CONCLUSION
PGL recurrence is rare but non-negligible. PGLs adjacent to major arteries complicate surgery, and perioperative hemodynamic stability demands meticulous attention.
Core Tip: Recurrent retroperitoneal paragangliomas are infrequent but pose substantial surgical challenges, particularly when located adjacent to critical vascular structures such as the abdominal aorta. Effective perioperative management of hemodynamic fluctuations, driven by catecholamine secretion, requires meticulous preoperative planning, including volume expansion, blood pressure monitoring, and vasoactive agent preparation. Surgical intervention demands prompt and coordinated anesthetic support to stabilize hemodynamics, ensuring successful tumor resection. Given the potential for late recurrence, long-term follow-up is essential for early detection and management of asymptomatic recurrences.
