Retroperitoneal paraganglioma

Case contributed by Dr Michael P Hartung

Presentation

Staging of retroperitoneal mass.

Patient Data

Age: 45 years
Gender: Female

3 x 6 x 8 cm (AP X TR X CC) heterogeneously enhancing vascular mass with associated prominent posterior draining veins which appear to be extending towards lumbar veins and close association if not loss of distinction with portions of the inferior vena cava. Mass is predominantly along the rightward aspect of the abdominal aorta but does have a small portion draping along the anterior aspect near the level of the origin of the IMA. There is some associated thickening of the aorta and iliac vessels and distal to the mass, with uncertain significance. Other retroperitoneal lymph nodes are small. The mass displaces the pancreas and the second/third portion of the duodenum anteriorly.

Case Discussion

This patient presented with a known diagnosis of retroperitoneal paraganglioma based on biochemical (catecholamine/metanephrine) evidence. The mass is confined to the retroperitoneum with broad vascular contact, and may be inseparable from the IVC and require grafting for surgical planning. 

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