Case Report


An unusual presentation of Mesenteric Paraganglioma

,  ,  ,  ,  

1 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia Portugal

2 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia Portugal

3 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia Portugal

4 MD, Director of the General Surgery Service in the Hospital de Santa Lúzia Portugal

5 MD, Colorectal Surgeon of General Surgery in the Hospital de Santa Lúzia Portugal

Address correspondence to:

Manuel Alexandre Viana Ferreira

Rua António De Mariz, nº22, 4715-279 Braga,

Portugal

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Article ID: 100955Z01MF2018

doi: 10.5348/100955Z01MF2018CR

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How to cite this article

Ferreira MAV, Martins A, Gonçalves Álvaro, Midões A, Torres R. An unusual presentation of Mesenteric Paraganglioma. Int J Case Rep Images 2018;9:100955Z01MF2018.

ABSTRACT


Introduction: Paragangliomas are rare tumors derived from neural crest cells, which are mostly localized in the adrenal medulla. Only 5–10% occur in extra-adrenal localizations. Given the potential of the paraganglioma to secrete catecholamines, some patients present constitutional symptoms such as headaches, tremors and hypertension. However, most patients are asymptomatic. Preoperative diagnosis of paraganglioma in asymptomatic patients is difficult but should be included in the differential diagnosis of solid mesenteric tumors. The gold standard therapy is complete resection, with the need for a long-term follow-up after surgery.

Case Report: Our case study takes a look at a 32-year-old nulliparous woman observed in the emergency room with a severe low abdominal pain. The ultrasonography and computerized tomography revealed a large pelvic tumor with apparent origin in the left ovary. During an exploratory laparotomy, an encapsulated, well vascularized mass was found in the mesentery of the ileum, behind the uterus, conditioning the twisting and consequent bottlenecks of 30 cm of the small intestine. An enterectomy was performed and the final histopathology revealed a 6 cm paraganglioma.

Conclusion: This case is unique due to its unusual location and clinical presentation. Only 20 cases of mesenteric paraganglioma are described and this is the first found in the context of an emergency.

Keywords: Chromaffin, Extra-adrenal, Paraganglioma, Paraganglia

SUPPORTING INFORMATION


Author Contributions:

Manuel Alexandre Viana Ferreira - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Aires Martins - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Álvaro Gonçalves - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Alberto Midões - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Rui Torres - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source Of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this case report.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2018 Manuel Alexandre Viana Ferreira et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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