Single-stage Resection of Cholecystic Carcinoma with Comorbid Paraganglioma—A Case Report—

Abstract

A 79-year-old woman receiving treatment for hypertension presented with epigastric pain. Abdominal contrast-enhanced computed tomography showed a cholecystic tumor and a retroperitoneal tumor, and she was admitted for further investigation and treatment. The retroperitoneal tumor was suspected to be a lymph node metastasis, but magnetic resonance imaging showed cholecystic carcinoma and a comorbid paraganglioma. On functional diagnosis, blood and urine tests showed elevated catecholamines, confirming the diagnosis, and single-stage surgery was performed. After radical cholecystectomy, the paraganglioma was removed, but it was located on the posterior surface of the inferior vena cava and had numerous feeding vessels that made it difficult to detach, and abnormal hypertension occurred at one point during the surgery. Because this condition of the patient was predicted by preoperative diagnosis, the anesthetist was able to make the appropriate decisions, and the surgery was performed safely. Paraganglioma rarely occurs in combination with gastrointestinal cancer ; it must be carefully differentiated from other conditions such as lymph node metastasis, and advance preparation for difficulties during surgery are important. Since malignancy is also a possibility, its course needs carefully longterm follow up.