Abstract
Paragangliomas are rare tumors of the neuroendocrine system that form near certain blood vessels (paraaortic and carotid) and nerves, often presenting heterogeneous parenchyma and displaying strong contrast enhancement on computed tomography. Underdiagnosis and misdiagnosis of this tumor are suspected as they can be silent, of small size, or confused with other structures.
Keywords: paraganglioma, retroperitoneal CT scan
1. INTRODUCTION
Paraganglioma is a rare neuroendocrine primary tumor derived from a specific type of nerve cell that is found throughout the body called chromaffin cells, which function in regulating blood pressure. 1 , 2 It accounts for 10%–20% of retroperitoneal tumors and can occur at any age, but often diagnosed in the 30–50 age group. It is usually benign, but some can become malignant and metastasize. 1 , 2 Paragangliomas originate from the para‐ganglionic system and called pheochromocytoma when it happens in the adrenal glands. Paragangliomas remain rare with a prevalence of 1/2000 to 1/6500. 1 , 2 Clinical signs (hypertension, tachycardia, headache, and diaphoresis) are due to the secretion of catecholamines.
Paragangliomas can occur anywhere, in the head/neck area near the carotid, in the paraaortic region. These tumors are frequently found in the infrarenal area near the origin of the inferior mesenteric artery, where the organs of Zuckerkandl are located. 1 , 2 On contrast‐enhanced computed tomography, these tumors appear as paraaortic soft tissue masses with intense contrast enhancement (Figure 1).
FIGURE 1.
Contrast‐enhanced abdominal computed tomography, axial (A), and coronal (B) view showing a left retroperitoneal paraganglioma (red head arrow) as a rounded, hypodense, heterogeneous, and intensely enhanced tissue mass in contact with the lower renal pole and the renal vascular pedicle (green arrow) in a patient consulting for secondary arterial hypertension.
The diagnosis of extraadrenal retroperitoneal paragangliomas remains a challenge due to the silent evolution of paraganglioma. The importance of radiological knowledge of these tumors is due to their silent presentation and variable radiological appearance.
AUTHOR CONTRIBUTIONS
Romeo Thierry Yehouenou Tessi: Conceptualization; supervision; validation; visualization; writing – original draft; writing – review and editing. Mustapha Outznit: Conceptualization; supervision; validation; visualization; writing – review and editing. Ittimade Nassar: Supervision; validation; visualization; writing – review and editing. Nabil Moatassim Billah: Supervision; validation; visualization; writing – review and editing.
2. FUNDING INFORMATION
All authors have declared that they have no financial support for this work.
CONFLICT OF INTEREST
We have no conflict of interest to declare.
ETHICAL APPROVAL
Ethics approval is not required for de‐identified single case reports based on institutional policies.
CONSENT
Consent for publication was obtained in accordance with the journal's patient consent policy.
ACKNOWLEDGMENT
We acknowledge all the staff member of Radiologie centrale of University Hopsital center Ibn Sina especially Pr Nassar (chief service ) and Pr Moatassim Billah.
Yehouenou Tessi RT, Outznit M, Nassar I, Moatassim Billah N. Retroperitoneal paraganglioma. Clin Case Rep. 2022;10:e06674. doi: 10.1002/ccr3.6674
REFERENCES
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