title: Diaphoresis and abdominal pain caused by extra-adrenal paragangliomas.
abstract: A 63-year-old lady presented with suprapelvic pain, weight loss and night sweats. On examination, she was noted to be hypertensive with a distended abdomen. Imaging (CT) revealed a 9.5 cm retroperitoneal mass with a high degree of vascularity and necrotic centre. The patient's urinary and plasma catecholamines were significantly raised and subsequent radio-isotope scan suggested the tumour was likely to be of a neuroendocrine nature. A diagnosis of a malignant paraganglioma was made. Malignant paragangliomas derive from sympathetic tissue and secrete catecholamines. Diagnostic uncertainty might lead to biopsy of tumour but this carries a high-risk of catecholamine-induced complications such as hypertensive crisis, cardiac arrhythmias and cardiac ischaemia and must be avoided.
authors: Guy's & St Thomas's NHS Foundation Trust, London, UK.
authors: Lennard
authors: L
authors: Lee
authors: Wei Lin
authors: WL
authors: Sung
authors: Mohammed Majid
authors: MM
authors: Akhtar
authors: Martin
authors: M
authors: Whyte
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D008676:Metanephrine / Q000097:blood / Q000652:urine; D008875:Middle Aged; D009647:Normetanephrine / Q000097:blood / Q000652:urine; D010236:Paraganglioma, Extra-Adrenal / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D013546:Sweating; D014057:Tomography, X-Ray Computed
chemical_list: D009647:Normetanephrine; D008676:Metanephrine