CASE REPORT article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1614545
An unexpected retroperitoneal paraganglioma with hypertensive crisis during surgical resection: A case report and literature review
Provisionally accepted
- 1The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, China
- 2Department of Anesthesiology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, China
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Retroperitoneal paraganglioma is an extremely rare tumor. Its atypical clinical presentations often lead to missed and misdiagnosis. Here, we report a 60-year-old male with unexplained weight loss and a medical history of hypertension and diabetes. Preoperative evaluations showed a left lower abdominal mass, considered as a malignant gastrointestinal stromal tumor or a leiomyosarcoma. During the laparoscopic resection of tumor, his blood pressure fluctuated significantly, especially with the tumor manipulation that caused hypertensive crisis. Phentolamine infusion was given to control the blood pressure, and the tumor was removed under the open abdominal surgery. Further laboratory tests on catecholamine levels and postoperative histopathology confirmed the diagnosis of retroperitoneal paraganglioma. Follow-up showed good recovery with no complications. Paraganglioma should be considered when an unknown mass with severe blood pressure fluctuations is encountered during surgery. Careful preoperative preparations and close intraoperative monitoring should be applied in patients with suspected paraganglioma.
Keywords: Anesthesia, Retroperitoneal paraganglioma, Hypertensive crisis, catecholamine, Intraoperative management
Received: 22 Apr 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Shen, Xuan, Chen, Lu, Lei, Huang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianliang Sun, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou, China
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