A Rare Case of a Retroperitoneal Paraganglioma: A Case Report

Abstract

Retroperitoneal paraganglioma is a rare neoplasm that develops from chromaffin cells that secrete catecholamines in the sympathetic ganglia. They are frequently functional and may be benign or malignant depending on the presence of metastasis and/or the occurrence of recurrence. Different imaging modalities play a crucial role in detecting these tumors. The typical CT appearance of PG is that of a well limited isodense mass with an intense contrast enhancement. On MRI, the mass presents an isosignal or hyposignal in T1 and hypersignal in T2 with an early and intense enhancement. The final diagnosis is based on histological and immunohistochemical findings and the surgical excision is the mainstay of the treatment. However, these tumors are often difficult to diagnose and treat. We report a case of a 30-year-old female patient who presented with a 3 months history of constipation, revealing on computed tomography (CT) a retroperitoneal mass lateralized on the right with a close connection to the inferior vena cava. Urine normetadrenaline (metanephrine) was elevated at 451 ug/24h. Neck and chest CT scan and scintigraphy with 123-I labeled metaiodobenzylguanidine (MIBG) were negative. Complete resection of the tumor was performed. The histological examination and immunohistochemical analyses concluded the diagnosis of a paraganglioma.