Undiagnosed paraganglioma; A challenge during laparoscopic retroperitoneal resection

  • Alexander Heinze | alexander@heinzemg.com SLK Kliniken Heilbronn, Department of Urology, University of Heidelberg, Germany; School of Medicine, Universidad Nacional Autónoma de México, México City, Mexico.
  • Periklis Nikomanis SLK Kliniken Heilbronn, Department of Anaesthesiology, University of Heidelberg, Germany.
  • Ferdinand Petzold SLK Kliniken Heilbronn, Department of Anaesthesiology, University of Heidelberg, Germany.
  • Jens Jochen Rassweiler SLK Kliniken Heilbronn, Department of Urology, University of Heidelberg, Germany.
  • Ali Serdar Goezen SLK Kliniken Heilbronn, Department of Urology, University of Heidelberg, Germany.

Abstract

Objective: Report our experience of the management of a patient with undiagnosed retroperitoneal paraganglioma and the intraoperative complications that the theatre team faced.
Case report: We present a case of a 36-year-old patient who during oncological follow-up for a previous diagnosis of parotid acinar cell carcinoma was incidentally identified as having an interaortocaval tumour. Following routine preoperative assessment the patient was arranged to undergo a laparoscopic retroperitoneal tumour resection. After minimal tumour manipulation the patient developed cardiac rhythm abnormalities and became hypertensive. The tumour was successfully removed laparoscopically after a cautious inter- aortocaval dissection. Abruptly, prior to extraction of the tumour containing endobag, the patient developed cardiac arrest. Following 35 minutes of life support measures there was a return of spontaneous circulation. The endobag was laparoscopically removed from the abdominal cavity 24 hours later using the initial operative port sites. The patient´s progression was satisfactory and he could be discharged six days postoperatively.
Conclusions: Asymptomatic undiagnosed paragangliomas represent a real challenge during laparoscopic operations. Haemodynamic changes and life-threatening events can arise acutely intraoperatively, where an immediate and coordinated response of the whole theatre team may be required to avoid fatal outcome.

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Published
2019-01-17
Info
Issue
Section
Case Reports
Keywords:
Paraganglioma, Laparoscopic approach, Intraoperative complications.
Statistics
  • Abstract views: 649

  • PDF: 250
How to Cite
Heinze, A., Nikomanis, P., Petzold, F., Rassweiler, J. J., & Goezen, A. (2019). Undiagnosed paraganglioma; A challenge during laparoscopic retroperitoneal resection. Archivio Italiano Di Urologia E Andrologia, 90(4), 297-298. https://doi.org/10.4081/aiua.2018.4.297