Organ of Zuckerkandl: Laparoscopic Excision of a Rarity

Abstract

Paragangliomas are rare neuroendocrine tumours of chromaffin cells, which may be derivatives of either sympathetic or parasympathetic chain and can be clinically secretory or non-secretory. Here, we present a case of a 28-year-old lady with symptomatic sympathetic paraganglioma of the organ of Zuckerkandl treated with laparoscopic excision, who presented with intermittent bouts of pain in the lower abdomen and generalised headaches. She was diagnosed in the ER with a suspected ovarian torsion and referred to the gynaecologist. In the operating room, she experienced repeated episodes of extreme hypertension and tachycardia, whilst the ovaries were found to be normal, and was transferred to the intensive care unit. On imaging and lab reports, a paraganglioma, organ of Zuckerkandl involvement, was suspected. After stabilisation, counselling, and pre-operative preparation, she underwent a successful laparoscopic excision, confirmed with HPE examination. She had an unremarkable post-op stay and follow-up until 6 months post-operatively.