Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

Stiru,Ovidiu; Dragan,Anca; Adamache,Cristina; Dragulescu,Petru Razvan; Stiru,Carmen; Tulin,Adrian; Bacalbasa,Nicolae; Balescu,Irina; Diaconu,Camelia; Geana,Roxana Carmen; Savu,Cornel; Iliescu,Vlad Anton

doi:10.3892/etm.2021.9975

May-2021 Volume 21 Issue 5

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May-2021 Volume 21 Issue 5

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Article

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

Authors:
- Ovidiu Stiru
- Anca Dragan
- Cristina Adamache
- Petru Razvan Dragulescu
- Carmen Stiru
- Adrian Tulin
- Nicolae Bacalbasa
- Irina Balescu
- Camelia Diaconu
- Roxana Carmen Geana
- Cornel Savu
- Vlad Anton Iliescu
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Affiliations: Department of Cardiovascular Surgery, ‘Prof. Dr. C. C. Iliescu’ Institute of Emergency for Cardiovascular Diseases, 022322 Bucharest, Romania, Department of Neurology, ‘Prof. Dr. Agripa Ionescu’ Clinical Emergency Hospital, 011356 Bucharest, Romania, Department of General Surgery, ‘Prof. Dr. Agripa Ionescu’ Clinical Emergency Hospital, 011356 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, ‘Ponderas’ Academic Hospital, 021188 Bucharest, Romania, Department of Internal Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Thoracic Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
Article Number: 543
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Published online on: March 23, 2021

https://doi.org/10.3892/etm.2021.9975
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Abstract

Paragangliomas are extremely rare neuroendocrine tumors. We report a case of a 44‑year‑old man with hypertension who presented a tumoral mass located retroperitoneally at the aortic bifurcation which included both the common iliac arteries and the posterior left iliac vein, who experienced an unpredictable intraoperative cardiac arrest with electromechanical dissociation at 5 min after laparotomy. After successful resuscitation and hemodynamic stability, the lesion was fully excised. In the course of tumor manipulation, the patient developed a major hypertensive crisis with peak systolic blood pressure over 280 mmHg. Pathologic examination revealed the presence of diffuse proliferation of large and medium‑sized mature adipocytes consistent with paraganglioma diagnosis. The patient was discharged at home on the seventh postoperative day. He did not present evidence of recurrence at the one‑year follow‑up. In conclusion, paragangliomas can require particular management due to their location but also due to their capacity to discharge substances which might induce life‑threatening intraoperative complications.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Abdominal paraaortic paraganglioma: Management of intraoperative hemodynamic emergencies during elective resection procedures (A case presentation)

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