title: A decade of clinical experience with extra-adrenal paragangliomas of retroperitoneum: Report of 67 cases and a literature review.
abstract: OBJECTIVE
  The purpose was to highlight the diagnosis and treatment of extra-adrenal para-gangliomas, which often causes catecholamine hypersecretion and hypertension.
  
  
  METHODS
  67 cases of extra-adrenal paraganglioma of retroperitoneum proven pathologically from 1999 to 2009 were reviewed and studied after operation. Endocrine secretion examinations, B-US, CT, MRI, 131-MIBG, octreotide and hands microcirculation inspection were used to diagnose the disease.
  
  
  RESULTS
  All patients underwent successful surgical resection of the tumors, which proved to be paragangliomas. They were from 3 cm to 25 cm in size. Almost all of them were diffusely positive for cgA, syn, NSE and s-100 by immunohitochemical staining. There were nine cases assayed malignant paraganglioma by the follow-up.
  
  
  CONCLUSIONS
  131-MIBG and octreotide have high sensitivity and accuracy in diagosing extra-adrenal paraganglioma. Surgical treatment should be carried out on the basis of correct drug preparation of α-receptor blocker, such as prazosin and phenoxybenzamine. Complete surgical excision is the treatment of choice for extra-adrenal paragangliomas as well as recurrent or metastatic disease, which could be resected laparoscopically. Intimate lifelong follow-up is necessary and important.
authors.affiliation: Department of Urology, PeKing Union Medical College Hospital, Chinese Academy of Medical Sciences and PeKing Union Medical College, Beijing 100730, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wen
authors.forename: Han-Zhong
authors.initials: HZ
authors.lastname: Li
authors.forename: Zhi Gang
authors.initials: ZG
authors.lastname: Ji
authors.forename: Quan Zhong
authors.initials: QZ
authors.lastname: Mao
authors.forename: Bing Bing
authors.initials: BB
authors.lastname: Shi
authors.forename: Wei Gang
authors.initials: WG
authors.lastname: Yan