title: Paraganglioma in a young patient with asymptomatic severe hypertension: a case report and review of the literature.
abstract: We present a case of a 19-year old woman who was admitted to our department with a recently, and incidentally, diagnosed severe hypertension [220/140 mmHg systolic/diastolic blood pressure (BP)]. The patient was asymptomatic. The laboratory investigation demonstrated both elevated plasma norepinephrine (1807 pg/ml, normal range 120-350 pg/ml) and 24h urinary free catecholamines (483 µg/24h, normal range <150 µg/24h), making the diagnosis of a catecholamineproducing tumor highly probable. Although magnetic resonance imaging of the abdomen showed normal adrenal glands, it revealed a mass (4x4 cm) anterior to the inferior vena cava. The diagnosis of paraganglioma was confirmed by the (131)Imeta- iodobenzylguanidine scintigraphy. Preoperatively, α- and β-adrenergic receptor blockers were administered. After successful resection of the tumor, the patient's BP was restored to normal and remained stable during the 3-month follow up. Plasma and 24h urinary catecholamine levels were also normalized. In conclusion, it is important to consider paragangliomas as a possible cause of secondary hypertension and proceed to diagnosis and treatment as described above, since surgical removal of the tumor, especially in sporadic cases, may cure the patient.
authors.forename: Ch
authors.initials: Ch
authors.lastname: Koumaras
authors.forename: P
authors.initials: P
authors.lastname: Anagnostis
authors.forename: M
authors.initials: M
authors.lastname: Tzimou
authors.forename: I
authors.initials: I
authors.lastname: Giavanidis
authors.forename: Th
authors.initials: T
authors.lastname: Gossios
authors.forename: A
authors.initials: A
authors.lastname: Antoniadis
authors.forename: V G
authors.initials: VG
authors.lastname: Athyros
authors.forename: A
authors.initials: A
authors.lastname: Karagiannis