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小野寺 篤，他
Abstract
A CASE OF A GIANT CATECHOLAMINE-PRODUCING RETROPERITONEAL PARAGANGLIOMA
THAT SHOWED DYNAMIC BLOOD PRESSURE CHANGES DURING SURGERY
Atsushi Onodera, Kentaro Hara, Hiroshi Tamagawa,
Norio Yukawa, Munetaka Masuda, Yasushi Rino
Department of Surgery, Yokohama City University Hospital
A case of a giant catecholamine-producing retroperitoneal paraganglioma that showed dynamic blood pressure
changes during surgery is reported. A 76-year-old man was referred to our hospital because of a 10×10×9 cm3sized retroperitoneal tumor that was accidentally found on computed tomography (CT) to investigate a cough. The
tumor showed low- and high-intensity signals on T1- and T2-weighted MR images, respectively. Positron emission
tomography (PET)/CT showed fluorodeoxyglucose (FDG) accumulation in the tumor. Endoscopic ultrasoundguided fine needle aspiration was performed, and immunostaining examinations were positive for synaptophysin
and alpha-fetoprotein (AFP). An endocrine examination of blood and urine showed high levels of catecholamines
and their metabolites. The patient was diagnosed with paraganglioma and underwent surgical resection. The tumor
was located between the inferior vena cava and the abdominal aorta, and the cranial side had grown over the left
renal vein. The blood pressure was significantly increased during intraoperative tumor exclusion and then decreased
rapidly after tumor removal, which suggested the effect of catecholamine production in the tumor. Postoperative
blood and urinary catecholamine levels were significantly lower than before surgery.
530
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