Retroperitoneal paraganglioma-Is pre operative embolization useful?

Autor: Apentchenko Eriutina N; Department of General and Digestive Surgery, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain., Castellón Pavón CJ; Department of General and Digestive Surgery, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain., García Vásquez C; Department of General and Digestive Surgery, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain. Electronic address: cgarciava@quironsalud.es., Gonzalo Montesinos I; Department of Endocrinology, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain., Jiménez de Los Galanes S; Department of General and Digestive Surgery, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain., Pacheco Martínez PA; Department of General and Digestive Surgery, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain., Gómez Patiño J; Department of Radiology, Hospital Universitario Infanta Elena, Valdemoro, Madrid, Spain.
Jazyk: angličtina
Zdroj: International journal of surgery case reports [Int J Surg Case Rep] 2017; Vol. 39, pp. 64-68. Date of Electronic Publication: 2017 Aug 05.
DOI: 10.1016/j.ijscr.2017.07.038
Abstrakt: Introduction: Paragangliomas (PG) are rare tumors derived from chromaffin cells that are located outside the adrenal gland and are capable of producing catecholamines. The treatment is based on a surgical resection, and there is controversy regarding the usefulness of previously carrying out an embolization and what is the most adequate surgical approach.
Clinical Case: We will present a 17-year-old woman with a retroperitoneal tumour in contact with the aorta and the inferior vena cava, treated with embolization prior to the surgical resection via laparotomy.
Discussion: The PG tumors are very infrequent and originate in the extra-adrenal chromaffin cells that exist in the vicinity of the components of the autonomic nervous system. Most of them (86%) produce catecholamines, are unique, sporadic, benign and more frequent in middle-aged women. Since they are radioresistant tumors, the only possibility for a cure is by a complete surgical excision. The preoperative embolization has been described mainly as the treatment of cervical PG, although its use in abdominal PG is more controversial and is not done in a systematic manner.
Conclusion: We can conclude that the embolization of abdominal PG is not free of risks and that it has not been demonstrated that it significantly reduces the peri-operative bleeding or the surgical time. Probably, the embolization should be reserved for intensively hypervascularized and larger PGs.
(Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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