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Surgery
Retroperitoneal venous malformation mimics paraganglioma on triple imaging modalities
  1. Paul Brian Ng Hung Shin1,
  2. Alexander Lombardo2 and
  3. Katherine Black2
  1. 1General Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  2. 2Princess Alexandra Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Paul Brian Ng Hung Shin; brian_ng{at}live.com.au

Abstract

Here, we report a case of a woman in her 50s who was referred for an incidentally discovered lesion anterior to the origin of inferior vena cava suspicious for a paraganglioma following a CT scan for vaginal bleeding. A follow-up 68Ga-DOTATATE PET-CT and MRI of the abdomen reinforced the radiological impression of an extra-adrenal paraganglioma (EAP). The EAP was deemed non-functional given normal urine biogenic amine, supine plasma fractionated metanephrines and chromogranin A levels. The mass was resected laparoscopically without perioperative blockade. Histological examination revealed a venous malformation. Extrahepatic abdominal venous malformations are rare and can be indistinguishable from an EAP on imaging preoperatively. Although benign, the lesion nevertheless warrants excision as it is associated with a risk of haemorrhage.

  • Endocrinology
  • Hemangioma
  • General surgery

https://doi.org/10.1136/bcr-2023-258708

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: PBNHS, AL and KB. The following authors gave final approval of the manuscript: PBNHS, AL and KB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.