Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2025; 13(12): 98721
Published online Apr 26, 2025. doi: 10.12998/wjcc.v13.i12.98721
Precision en-bloc retroperitoneal paraganglioma resection performed laparoscopically: A case report
Jia-Le Zhou, Fei Xie
Jia-Le Zhou, Department of Hepatobiliary and Pancreatic Surgery, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
Fei Xie, Department of Hepatobiliary and Pancreatic Surgery, The Neijiang First People’s Hospital, Neijiang 641000, Sichuan Province, China
Author contributions: Zhou JL conducted the initial draft writing and research design; Xie F reviewed the manuscript; and all authors read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Xie, Professor, Department of Hepatobiliary and Pancreatic Surgery, The Neijiang First People’s Hospital, No. 1866 West Section of Hanan Avenue, Shizhong District, Neijiang 641000, Sichuan Province, China. whitetower@163.com
Received: July 4, 2024
Revised: October 12, 2024
Accepted: December 17, 2024
Published online: April 26, 2025
Processing time: 187 Days and 15.7 Hours
Abstract
BACKGROUND

Phaeochromocytoma and paragangliomas (PPGL) are rare neuroendocrine tumors usually caused by parasympathetic or sympathetic nerves, with an overall incidence of approximately 0.66 cases per 100000 people per year. Most PPGLs are asymptomatic, and a few develop symptoms, such as elevated blood pressure and rapid heart rate, because of the release of catecholamines. According to the literature, surgical resection is the mainstay of PPGL treatment. However, the choice between minimally invasive surgery and open surgery remains controversial, particularly in cases involving complex anatomical relationships. We successfully resected a tumor located between the inferior vena cava and abdominal aorta using a minimally invasive approach with the assistance of computed tomography (CT) angiography and three-dimensional reconstruction, resulting in a favorable outcome.

CASE SUMMARY

A 56-year-old woman was admitted to the hospital with right upper abdominal discomfort for more than 6 months, experiencing occasional pins and needles sensation and radiation from the right shoulder and back. Prehospital CT of the upper abdomen revealed a retroperitoneal mass suspected to be a retroperitoneal ganglioneuroma. Surgery was recommended, and an enhanced CT scan of the upper abdomen, along with preoperative three-dimensional reconstruction, was performed after admission. The imaging indicated that the mass, measuring approximately 4.1 cm × 3.8 cm × 4.8 cm, was situated between the abdominal aorta and the inferior vena cava, extending downward to the level of the left renal vein. After ruling out any contraindications to surgery, a minimally invasive laparoscopy was performed to excise the mass precisely. The surgery was successful without any postoperative complications, and the 2-month follow-up revealed no abnormal signs of recurrence.

CONCLUSION

This case report describes successful and precise laparoscopic resection of a retroperitoneal tumor. The patient recovered well during the 2-month follow-up, and postoperative pathology revealed a paraganglioma.

Keywords: Pheochromocytomas; Paragangliomas; Treatment; Laparoscopic; Case report

Core Tip: The surgical resection of retroperitoneal paragangliomas (PGL) is widely acknowledged as the most effective therapeutic approach. Surgical methods are primarily divided into laparoscopic and traditional open surgeries. Although there is some debate regarding the choice between these two surgical modalities, laparoscopic surgery has become the preferred method for the excision of such tumors because of its minimally invasive nature. Compared with open surgery, the increased risk of significant trauma and postoperative complications cannot be overlooked. In this case, with the aid of advanced imaging technology, we successfully performed laparoscopic resection of a PGL in an anatomically complex region, achieving satisfactory therapeutic outcomes. This study provides new perspectives on the use of laparoscopy to address complex PGLs.