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Giant retroperitoneal paraganglioma: Challenges of misdiagnosis and high surgical risks, a case report

INTRODUCTION AND IMPORTANCE: In surgery, misdiagnosis is not uncommon, usually a result of erroneous image interpretations and pathology diagnosis especially involving a tumor or cancer. Misdiagnosis may cause increased morbidity, mortality and surgical risks. CASE PRESENTATION: A 49-year-old man pr...

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Detalles Bibliográficos
Autores principales: Huang, Zhengbin, Liu, Hanzhong, Huang, Wenwei, Wang, Hui, Liu, Jun, Wu, Zhengqi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209176/
https://www.ncbi.nlm.nih.gov/pubmed/34119947
http://dx.doi.org/10.1016/j.ijscr.2021.106081
Descripción
Sumario:INTRODUCTION AND IMPORTANCE: In surgery, misdiagnosis is not uncommon, usually a result of erroneous image interpretations and pathology diagnosis especially involving a tumor or cancer. Misdiagnosis may cause increased morbidity, mortality and surgical risks. CASE PRESENTATION: A 49-year-old man presented for the second time with a right upper abdominal mass of 7 months. Previous CT scan of abdomen and exploratory surgery made the diagnosis of liver cancer. Two other tertiary hospitals drew the similar conclusions. At a cancer hospital the needle biopsy was suspicious for gastrointestinal stromal tumor, Imatinib was recommended but not started due to high cost. During this re-admission, the diagnosis of liver cancer or GIST was challenged. A high risk surgery was done with successive removal of a giant tumor. A final diagnosis of paraganlioma was made and the patient is now tumor free for 6 years. CLINICAL DISCUSSION: There are 4 lessons from this case. First, a paraganlioma may be misdiagnosed. Second, the misdiagnosis may be misled by CT scan and pathology. Third, a misdiagnosis can cause increased morbidity, mortality and surgical risks. Forth, massive intraoperative hemorrhage is a high risk of surgery. CONCLUSION: Careful clinical evaluation combined with pathology diagnosis may reduce the misdiagnosis of some tumor/cancer. Surgical resection may be the only way to reach a diagnosis in patient with paraganlioma. Massive intraoperative hemorrhage is a high risk of surgery in such patients.