Primary hypertension in a postoperative paraganglioma patient: A case report

BACKGROUND: Primary hypertension is a common clinical disease. Pheochromocytoma and paraganglioma is a rare cause of secondary hypertension. The diagnosis of the latter is still difficult, and the relationship between the two is not clear. The successful diagnosis of this case confirmed that standardized etiological investigation of secondary hypertension is necessary, contributes to the accurate diagnosis of rare diseases, and is conducive to the formulation or optimization of treatment plans. It shows an example of the coexistence of primary hypertension and secondary hypertension. CASE SUMMARY: The patient was a 54-year-old male and was hospitalized with high blood pressure for 4 years. The patient’s blood pressure was measured at 150/100 mmHg during physical examination 4 years ago and had no paroxysmal or persistent elevated blood pressure, no typical triad of headache, palpitation, and sweating, without postural hypotension. After taking nifedipine sustained release tablets intermittently, the blood pressure did not meet the standard. Physical examination revealed blood pressure of 180/120 mmHg. There was no abnormality in cardiopulmonary and abdominal examination. The results of blood and/or urinary catecholamines/metanephrine and normetanephrine before and after operation were normal. Fundus examination revealed retinal arteriosclerosis in both eyes. There was a history of paraganglioma diagnosed by pathology after retroperitoneal tumor resection, a family history of hypertension, and a history of passive smoking. The clinical diagnosis was subclinical paraganglioma, primary hypertension, and hypertensive fundus lesions. The patient’s blood pressure was regulated, blood lipid was reduced, and anti-inflammatory, and symptomatic support were given. After treatment, the blood pressure was stable and up to standard without discomfort symptoms. CONCLUSION: Subclinical paraganglioma and primary hypertension can coexist. The holistic thinking in clinical practice is helpful to the early diagnosis of rare diseases.