Ryuta Watanabe, MD, Akira Ozawa, MD, Tokuhiro Iseda, MD
Department of Urology, Matsuyama Shimin Hospital, Ehime, Japan (all authors).
Introduction: Paraganglioma of the kidney seldom occurs and is rarely malignant. Because of anatomical characteristics and concerns about catecholamine release, surgery for these tumors is often deemed inappropriate. We present the case of a man with recurrent paraganglioma treated with laparoscopic resection.
Description: A 73-year-old man was referred to our department after an internal medicine check-up raised suspicion of a retroperitoneal tumor. Enhanced imaging revealed a 4.5-cm tumor that surrounded the left hilus of the kidney. We performed a retroperitoneal laparoscopic resection of all of the tumor, and pathology confirmed a paraganglioma. Approximately 2 years after surgery, a CT scan showed an enlargement of the rest of the tumor around the left hilus of the kidney. We performed a retroperitoneal laparoscopic resection of the recurring tumor. With some difficulty we resected much of the tumor. There was no sign of recurrence 11 months after the second surgery, but long-term follow-up is essential.
Conclusion: Our case study is among only a few in which laparoscopic resection of a retroperitoneal paraganglioma has been reported. The findings collectively suggest that we should be careful of strong adhesion and sudden hypertension during such operations.
Key Words: Idiopathic kidney injury, Retroperitoneal laparoscopic resection, Retroperitoneal paraganglioma, Second operation.