Surgical removal of retroperitoneal paraganglioma with aortic bifurcation resection and replacement: a case report
https://doi.org/10.21294/1814-4861-2025-24-4-155-161
Abstract
Background. Paragangliomas are rare neuroendocrine tumors that often located paravertebrally in the retroperitoneal space and near major abdominal blood vessels. Surgical resection is the primary treatment for paragangliomas. A close adjacency between a tumor and the main vessels requires a combined treatment approach: a surgical resection of a tumor along with a portion of the vascular trunk, ensuring that the removed tissue is within the healthy surrounding areas. Separation of the tumor from the vessel may potentially leave a microscopic margin of tumor cells on the vessel wall (R1 resection) and usually results in damage to the vessel and significant blood loss.
Case presentation. We present here the case of surgical treatment of paraganglioma of the organ of Zuckerkandl in a 52-year-old female patient. A close adjacency of the tumor to the aortic bifurcation required tumor resection involving the aortic bifurcation and subsequent reconstruction of the main blood flow using a Polytetrafluoroethylene (PtFe) bifurcation aorto-common iliac alloprosthetic graft (PtFe conduit). The postoperative period was uneventful. The patient is stable and is currently under follow-up care.
Conclusion. This case report demonstrates the feasibility of performing radical surgery in patients with retroperitoneal paragangliomas closely adjacent to the major vessels.
About the Authors
R. I. Rasulov
Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia ; Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Rodion I. Rasulov, MD, DSc, Professor, Head of the Department of Oncology; Deputy Chief Physician
100, Yubileyniy, Irkutsk, 664049
32, Frunze st., Irkutsk, 664035
A. A. Muratov
Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia ; Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Andrey A. Muratov, MD, PhD, Assistant, Department of Oncology; Oncologist, Department of Abdominal Oncology
100, Yubileyniy, Irkutsk, 664049
32, Frunze st., Irkutsk, 664035
A. G. Kuvshinov
Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Artem G. Kuvshinov, MD, PhD, Head of the Department of Abdominal Oncology
32, Frunze st., Irkutsk, 664035
A. P. Ponomarenko
Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Anna P. Ponomarenko, MD, Anesthesiologist, Anesthesiology and Resuscitation Department № 1
32, Frunze st., Irkutsk, 664035
A. M. Bulytov
Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Alexey M. Bulytov, MD, Radiologist, X-ray Diagnostics Department
32, Frunze st., Irkutsk, 664035
D. O. Malykh
Irkutsk Regional Cancer Center
Russian Federation
Russian Federation
Dmitry O. Malykh, MD, Anesthesiologist-Resuscitator, Anesthesiology and Resuscitation Department № 1
32, Frunze st., Irkutsk, 664035
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Supplementary files
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1. Fig. 1. CT image. Non-organ retroperitoneal tumor before surgery, arterial phase, frontal projection. Note: created by the authors | |
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2. Fig. 2. Intraoperative photo. Mobilization of a non-organ retroperitoneal tumor. Abdominal aorta and iliac vessels on silicone tourniquets. Note: created by the authors | |
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3. Fig. 3. Intraoperative photo. View of the abdominal cavity after removal of a non-organ retroperitoneal tumor. Note: created by the authors | |
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4. Fig. 4. Intraoperative photo. View of the surgical wound after vascular reconstruction. Note: created by the authors | |
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5. Fig. 5. Microphoto. Paraganglioma. Hematoxylin and eosin staining, ×400. Note: created by the authors | |
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6. Fig. 6. CT image of abdominal cavity after surgery, arterial phase, frontal projection. Note: created by the authors | |
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For citations:
Rasulov R.I., Muratov A.A., Kuvshinov A.G., Ponomarenko A.P., Bulytov A.M., Malykh D.O. Surgical removal of retroperitoneal paraganglioma with aortic bifurcation resection and replacement: a case report. Siberian journal of oncology. 2025;24(4):155-161. (In Russ.) https://doi.org/10.21294/1814-4861-2025-24-4-155-161
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