Paraganglioma in a Young Adult Female Patient: A Case Report

Abstract

Paragangliomas are catecholamine-secreting neuroendocrine tumors that originate from the chromaffin cells of the sympathetic ganglia. Roughly 10% of paragangliomas are malignant, resulting in a rare occurrence of 90-95 cases per 400 million people. Herein, we report a case of a 29-year-old female patient who presented with nausea, vomiting, and bloating and was found to have a large left retroperitoneal tumor upon imaging. The tumor was successfully removed, and subsequent histological analysis was compatible with the presence of a paraganglioma. This case serves as a reminder that despite its rarity, paragangliomas should never be dismissed as a differential diagnosis if correlating symptoms and diagnostic findings are consistent with that of paraganglioma etiology.

Keywords: catecholamine hypersecretion; malignancy surgery; neuroendocrine tumors; paraganglioma; tumor imaging.

Figure 1. Axial (A) and coronal (B) contrast-enhanced CT images show a large left retroperitoneal mass with multiloculated cystic and necrotic components, thin enhancing walls/septa, and isolated punctate calcifications. There is a mass effect on the upper pole of the left kidney.

Figure 2. (A) Intermediate magnification (100x) H&E photomicrograph demonstrating large epithelioid cells arranged in a somewhat nested fashion. These cells have a palely eosinophilic granular cytoplasm and notably atypical vesicular nuclei; (B) High magnification (400x) H&E photomicrograph demonstrating a cytologically malignant neoplasm consisting of quite large epithelioid cells arranged in a somewhat nested fashion. These cells have a palely eosinophilic granular cytoplasm and notably atypical vesicular nuclei.