Functional Hilar Paraganglioma Invading the Renal Veins: A Case Report Mohammed Alfozan

Abstract

A 39-year-old man with poorly managed hypertension was diagnosed with a large left retroperitoneal tumor compressing the renal vein. A CT scan of the abdomen and pelvis with contrast revealed a large, well-defined, capsulated, highly vascular, heterogeneous retroperitoneal para-aortic mass that was compressing the renal vein. Tests for catecholamines in the blood and urine revealed a functioning tumor. A multidisciplinary team, including anesthesiologists, endocrinologists, and urologists, prepared the patient for surgery. Due to the CT findings of the tumor being inseparable from the pancreas, a decision to utilize a midline trans-peritoneal approach. The tumor was compressing the vein but no effect on the blood flow can be noted in that imaging. The tumor noted to be draining into the renal vein during the surgery. The renal vein's width was reduced by less than 20% after the tumor was removed and the vein was reconstructed. The patient was weaned off medications and maintained blood pressure within acceptable ranges.