Combined thoracoscopic and laparoscopic approach to remove a large retroperitoneal compound paraganglioma: A case report

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Abstract

BACKGROUND

Paragangliomas (PGLs) are rare catecholamine-secreting neuroendocrine tumors, which often present with secondary hypertension. The most common location is the retroperitoneal space. For the first time, we report a rare case of large retroperitoneal compound PGL, and we have innovatively applied a new surgical plan to completely remove the tumor.

CASE SUMMARY

A 55-year-old middle-aged man was admitted to the hospital for fluctuating blood pressure for more than 1 year with intermittent headache. He suffered dozens of attacks every day. Blood and urine catecholamines were elevated, somatostatin receptor imaging was positive, and the diagnosis of PGL was clear. The imaging examination revealed a large tumor on the right front of the mediastinal spine at the level of T10-L1 (the posterior space of the right phrenic foot). For the first time in our department, a combined thoracoscopic and laparoscopic operation was used to detect and remove large tumors.

CONCLUSION

This is the first reported case of using a thoracoscopic and laparoscopic approach simultaneously to remove a large retroperitoneal compound PGL, which may provide a new surgical approach for similar cases.

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Most cited references 13

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Update on Adrenal Tumours in 2017 World Health Organization (WHO) of Endocrine Tumours.

Alfred Lam (2017)

The fourth edition of the World Health Organization (WHO) classification of endocrine tumours contains substantial new findings for the adrenal tumours. The tumours are presented in two chapters labelled as "Tumours of the adrenal cortex" and "Tumours of the adrenal medulla and extra-adrenal paraganglia." Tumours of the adrenal cortex are classified as cortical carcinoma, cortical adenoma, sex cord stromal tumours, adenomatoid tumour, mesenchymal and stromal tumours (myelolipoma and schwannoma), haematological tumours, and secondary tumours. Amongst them, schwannoma and haematological tumours are newly documented. The major updates in adrenal cortical lesions are noted in the genetics of the cortical carcinoma and cortical adenoma based on the data from The Cancer Genome Atlas (TCGA). Also, a system for differentiation of oncocytoma from oncocytic cortical carcinoma is adopted. Tumours of the adrenal medulla and extra-adrenal paraganglia comprise pheochromocytoma, paraganglioma (head and neck paraganglioma and sympathetic paraganglioma), neuroblastic tumours (neuroblastoma, nodular ganglioneuroblastoma, intermixed ganglioneuroblastoma, and ganglioneuroma), composite pheochromocytoma, and composite paraganglioma. In this group, neuroblastic tumours are newly included in the classification. The clinical features, histology, associated pathologies, genetics, and predictive factors of pheochromocytoma and paraganglioma are the main changes introduced in this chapter of WHO classification of endocrine tumours. The term "metastatic pheochromocytoma/paraganglioma" is used to replace "malignant pheochromocytoma/paraganglioma." Also, composite pheochromocytoma and composite paraganglioma are now documented in separate sections instead of one. Overall, the new classification incorporated new data on pathology, clinical behaviour, and genetics of the adrenal tumours that are important for current management of patients with these tumours.

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Benign paragangliomas: clinical presentation and treatment outcomes in 236 patients.

Mitchell G. Thompson, Lance D. Erickson, M Ebersold … (2001)

Paragangliomas are rare tumors that arise from extraadrenal chromaffin cells. We examined the clinical characteristics, location, treatment, and outcome of 236 patients (141 females, 60%) with 297 benign paragangliomas evaluated at the Mayo Clinic during 1978-1998. The mean age (+/-SD) at diagnosis was 47 +/- 16 yr. Of the 297 paragangliomas, 205 were in the head and neck region, and 92 were below the neck. Paragangliomas were discovered and diagnosed incidentally on imaging studies in 9% of patients. Biochemical screening was performed in 128 patients; 40 patients (17% of the total and 31% of those screened) had hyperfunctional tumors. Of the 40 patients with tumoral catecholamine excess, 38 had documented hypertension. In patients identified with catecholamine-secreting paragangliomas, the sensitivities achieved by measurements in the 24-h urine collection were 74% for total metanephrines, 84% for norepinephrine, 18% for dopamine, and 14% for epinephrine. Multiple imaging modalities were used for tumor localization. The false negative rates were 0% for magnetic resonance imaging, 5.8% for computed tomography, 3.4% for angiography, 10.7% for ultrasonography, and 39% for radioactive iodine-labeled metaiodobenzylguanidine scintigraphy. Of 192 patients (81.4%) with follow-up data (mean, 43.9 months; range, 0.5-240), operative cure was achieved in 133 (69%). Of the 59 patients without cure, 23 had persistent disease, 5 had recurrent disease, 16 had multiple persistent synchronous tumors, and 15 subsequently developed metachronous tumors. In conclusion, most paragangliomas are nonhypersecretory and located in the head and neck region. Magnetic resonance imaging was associated with the lowest false negative rate, and metaiodobenzylguanidine was the least sensitive imaging study. A significant proportion of patients (31%) has persistent or recurrent disease, and long-term follow-up is important.

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The management of benign and malignant pheochromocytoma and abdominal paraganglioma.

B. Hamberger, A Höög, A-L Hjelm Skog … (2003)

To report treatment and outcome in patients with malignant and benign pheochromocytoma and abdominal paraganglioma. Review of clinical and therapeutic features in 85 patients with pheochromocytoma or abdominal paraganglioma between 1976 and 1999. Thirty-nine of 85 patients presented with symptoms other than classical paroxysmal attacks. Paragangliomas were more often malignant (7/15) than pheochromocytomas (7/70). No recurrences have occurred in 71 patients with tumours initially classified as benign after a median follow-up time of 144 months (range 7-287). Nine of 14 patients with tumours classified as malignant have developed metastasis and/or local recurrence. Treatment of malignant tumours with cyclophosphamide, vincristine and dacarbazine (CVD) improved or stabilised the disease in three of four patients. Life long follow-up of patients with benign pheochromocytoma is not necessary. Combination chemotherapy (CVD) is a valid option in the treatment of malignant pheochromocytomas and abdominal paragangliomas.

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Author and article information

Contributors

Chang Liu

Jin Wen

Han-Zhong Li

Zhi-Gang Ji

Journal

Journal ID (nlm-ta): World J Clin Cases

Journal ID (publisher-id): WJCC

Title: World Journal of Clinical Cases

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 2307-8960

Publication date (Print): 16 August 2021

Publication date (Electronic): 16 August 2021

Volume: 9

Issue: 23

Pages: 6935-6942

Affiliations

Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. wjpumch@ 123456163.com

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Author notes

Author contributions: Liu C participated in the writing of the manuscript; Wen J contributed to the editing of the manuscript; Li HZ and Ji ZG served as scientific advisors; all authors have read and approved the final manuscript.

Supported by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences, No. 2019XK320027; and the Project Management Fund for Foreign Cultural and Educational Experts, No. G20190001645.

Corresponding author: Jin Wen, MD, Associate Professor, Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. wjpumch@ 123456163.com

Article

Other ID: jWJCC.v9.i23.pg6935

DOI: 10.12998/wjcc.v9.i23.6935

PMC ID: 8362544

PubMed ID: 34447845

SO-VID: d0258014-ae17-4885-8985-abce29d78d0f

License:

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: http://creativecommons.org/Licenses/by-nc/4.0/

History

Date received : 6 May 2021

Date revision received : 7 June 2021

Date accepted : 22 June 2021

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