Spontaneous retroperitoneal abscess as the first clinical manifestation of a non-functioning retroperitoneal paraganglioma

Abstract

We demonstrate a novel clinical presentation of paraganglioma not described in the literature. The paraganglioma is a catecholamine secretory, or non-secretory, neuroendocrine tumour that derives from chromaffin cells. Its frequency, with regard to pheochromocytoma, is low, and the abdominal region is the most frequent localisation site, followed in importance by the cervical region. We report the case of a 54-year-old woman diagnosed with a retroperitoneal abscess; after drainage of the lesion, samples indicated necrotic paraganglioma cells, so it was decided to conduct a survey to determine catecholamine levels in urine, and carry out a MIBG gammagraphy, which described a non-functioning retroperitoneal paraganglioma that underwent surgical removal. There was no residual disease after 3-month follow-up.

Figure 1

Abdominal-pelvic CAT: low attenuation area in retroperiton-eal zone; the mass compresses and displaces left kidney, left suprarenal gland and the tail of the pancreas.

Figure 2

NMR: mass compatible with retroperitoneal abscess.

Figure 3

Gammagraphy with I123 MIBG: anomalous increased radiotracer focus on a 40 mm × 45 mm mass localised in the intersection that lies below the inferior side of the tail of the pancreas, the upper pole of left kidney and left suprarenal area.