A case of successful resection of a large paraganglioma with reconstruction of the inferior vena cava

Abstract

The patient was a 45-year-old man who suddenly developed palpitations and a systolic headache. His blood pressure was extremely elevated and a large mass was found in the right adrenal region on abdominal computed tomography. His serum and urinary catecholamine levels were high. After α-blocker and hydration treatment, surgery was done. The tumor arose from a paraganglion and was diagnosed as a paraganlioma. While the blood pressure was controlled with α-blocker therapy, the inferior vena cava (IVC) was clamped and divided above the renal veins in orger to extend the surgical field. The tumor was extirpated, and the IVC was reconstructed. Postoperatively except for the urinary dopamine level, the serum and urinary catecholamine levels normalized, and his arterial blood pressure could be controlled. The patient was discharged on the 11^th postoperative day. The temporary division and reconstruction of the IVC to extend the surgical field is useful when resecting large retroperitoneal tumors.