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Case Reports
. 2025 Jan 21;2025(1):rjae842.
doi: 10.1093/jscr/rjae842. eCollection 2025 Jan.

Robotic-assisted excision of left para-aortic paraganglioma: a novel approach

Jack Kang Tan  1 , Jason Ramsingh  2
Affiliations
Case Reports

Robotic-assisted excision of left para-aortic paraganglioma: a novel approach

Jack Kang Tan et al. J Surg Case Rep. .

Abstract

Paragangliomas, a type of extra-adrenal tumour, albeit rare, are dangerous due to their high metastatic potential and risk of hypertensive crisis from massive catecholamine release. It typically presents with sympathetic overdrive symptoms such as diaphoresis, headache, and palpitation, accompanied by substantially high plasma metanephrines level and mass on contrasted computed tomography abdomen and pelvis, whilst some are found incidentally. In this report, we discuss a case of an extra-adrenal lesion located near susceptible major structures with extensive vascularisation, in a patient with near-death experience. Complete excision of the pulsatile mass with minimal bleeding and no complications, was made possible utilizing the da Vinci Robotic System. Robotic surgery, being a part of a multidisciplinary approach, leads to better patient outcomes and shorter hospitalisations. Moreover, it offers enhanced dexterity and improved depth perception compared to conventional methods. However, further studies are needed to validate its application in standard practice.

Keywords: daVinci; extra-adrenal; paraganglioma; pheochromocytoma; retroperitoneal; robotic.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Contrasted CT in arterial phase, in the axial plane, showed a contrast enhanced, hyperdense, heterogenous lesion located over the left para-aortic region, measuring ⁓2 × 2 × 3 cm with no septations or peripheral rim enhancement.
Figure 2
Figure 2
Contrasted CT of the abdomen and pelvis in arterial phase, coronal plane, revealed a similar mass, contrast enhanced heterogenous lesion with well demarcated borders, measuring ⁓2 × 2 × 3 cm, situated at the left para-aortic region.
Figure 3
Figure 3
Well circumscribed mass with extensive vascularisation is located and isolated, with no surrounding tissue necrosis or invasion observed. Real time video footage revealed a pulsatile mass.
Figure 4
Figure 4
Post tumour removal showed clean base with no active bleeding. No evidence of tissue invasion into peripheral structures.
See this image and copyright information in PMC

References

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