Laparoscopic resection of a ruptured retroperitoneal paraganglioma

Abstract

Laparoscopic resection of a retroperitoneal paraganglioma is considered challenging because of variable anatomical presentation and potential vascular injury during surgical manipulation. Due to the rarity of the entity, only a few studies using this technique have been reported. Furthermore, a ruptured paraganglioma which manifests in traumatic retroperitoneal hemorrhage is exceedingly uncommon.Herein, we reported a case of a 12-year-old girl who presented with a ruptured retroperitoneal paraganglioma due to abdominal blunt trauma. Her contrast-enhanced computed tomography scan revealed a retroperitoneal hemorrhage and an abdominal mass of approximately 4 cm in diameter surrounded by the aorta, inferior vena cava, and left renal vein. A preoperative diagnosis of retroperitoneal paraganglioma was made from her 24 hour urinary catecholamine level, a clonidine loading test, and 123I-MIBG scintigraphy and elective laparoscopic resection was performed. Despite of dense peritumoral adhesion, a clear and magnified view of the surgical field and meticulous manipulation of the tumor allowed this laparoscopic resection to be successful, minimally invasive, and safe.

Keywords

• Retroperitoneal paraganglioma
• Rupture
• Laparoscopic resection