Abstract
A 61-year-old woman was emergently admitted because of sickness during abdominal consultation. On admission, CT was performed for general examination. Subsequently, right breast cancer and a tumor on the left side of the abdominal aorta were identified. The abdominal tumor was preoperatively diagnosed as GIST originating from the mesothelium, and an operation was carried out. First, a muscle-preserving mastectomy was performed for the right breast cancer. Laparotomy was then performed ; however, severe hypertension as well as ventricular tachycardia occurred at the beginning of manipulation of the tumor. The resection was therefore abandoned. Subsequently, several tests were performed and the tumor was highly suspected to be a paraganglioma.
Re-operation was carried out 28 days after the first operation. The 70-mm tumor was growing in the retroperitoneal space. Eventually, the tumor was completely resected. Paraganglioma was pathologically diagnosed.
Paraganglioma is a tumor originating from a neural cell and is intraoperatively diagnosed in 2% of patients. In this case, the first operation was abandoned due to complications based on the outflow of catecholamine from the tumor. In case of a retroperitoneal tumor, preoperative examination considering possible paraganglioma is occasionally necessary. Furthermore, it is very important to preoperatively administer an α-blocker agent, in order to prevent the risk of intraoperative death.
