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Case Report
An unusual presentation of Mesenteric Paraganglioma
1 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia, Viana do Castelo, Portugal
2 MD, Director of the General Surgery Service in the Hospital de Santa Lúzia, Viana do Castelo, Viana do Castelo, Portugal
3 MD, Colorectal Surgeon of General Surgery in the Hospital de Santa Lúzia, Viana do Castelo, Portugal
Address correspondence to:
Manuel Alexandre Viana Ferreira
Rua António De Mariz, nº22, 4715-279 Braga,
Portugal
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Article ID: 100955Z01MF2018
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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
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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
Ãlvaro 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
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors 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.
