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Giant retroperitoneal paraganglioma in a young patient: A multidisciplinary challenge

VOLUMEN 5 - NÚMERO 1 / Enero - Marzo (Caso Clí­nico)


Manuel García-Sáenz, Departamento de Endocrinología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
Daniel Uribe-Cortés, Departamento de Endocrinología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
Aldo Ferreira-Hermosillo, Servicio de Endocrinología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
Claudia Ramírez-Rentería, Experimental Endocrinology Unit, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
Guillermo Montoya-Martínez, Departamento de Urología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
Alicia Estrada, Departamento Cirugía General, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
Katia Hop-García, Departamento de Patología, Hospital de Especialidades "Dr. Bernardo Sepúlveda", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
Perla Hernandez-Salcedo, Hospital General Regional No.1, Instituto Mexicano del Seguro Social, México

Introduction: A multidisciplinary evaluation in paragangliomas (PGLs) is required given the potential complications present at the time of diagnosis or related to the surgical management. Case Report: A 26-year-old male, presented with anxiety, panic attacks, pallor, sweating, and distal tremor, BP 230/130 mmHg, was selected. Plasmatic-free metanephrines were 6,392 pg/mL (normal <149 pg/mL), and computed tomography showed an extra-adrenal retroperitoneal mass of 63 × 51 mm. Preoperatory management was difficult and presented hyper- and hypo-tension during surgery (conventional laparotomy). He presented a new episode of hypertension after surgery, that was associated with renal exclusion and without residual tumor. Conclusion: Young patients, with PGLs, have long-life expectancies and can benefit from an opportune diagnosis, interdisciplinary management, and prolonged follow-up.

Palabras clave: Extra-adrenal paraganglioma. Retroperitoneal neoplasm. Metanephrines.

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