Case Report
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World J Radiol. Jan 28, 2014; 6(1): 15-17
Published online Jan 28, 2014. doi: 10.4329/wjr.v6.i1.15
Renal hilar paraganglioma: A case report
Zeinab Ali Abou Yehia, Rashid Khalid Sayyid, Ali Ahmad Haydar
Zeinab Ali Abou Yehia, Rashid Khalid Sayyid, Ali Ahmad Haydar, Department of Radiology, AUBMC, Riad El Solh, Beirut 1107 2020, Lebanon
Author contributions: Abou Yehia ZA, Sayyid RK and Haydar AA contributed to the writing of the case report in accordance with the standard proposed by the International Committee of Medical Journal Editors.
Correspondence to: Ali Ahmad Haydar, MD, Department of Radiology, AUBMC, PO Box. 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon. ah24@aub.edu.lb
Telephone: +9-613-539553 Fax: +9-611-743634
Received: September 30, 2013
Revised: November 11, 2013
Accepted: December 17, 2013
Published online: January 28, 2014
Abstract

Paragangliomas are extra-adrenal pheochromocytomas that derive from chromaffin cells and arise along the sympathetic paraganglia in the body. In the majority of cases, they are secretory tumors and most commonly present with palpitations. Plasma metanephrines are the standard screening tests for making the diagnosis which is confirmed by pathology. Imaging plays a very important role in establishing the diagnosis. However, there is no specific feature on imaging for paragangliomas; the vascularity of the tumor should show as hyper-enhancing lesions but this is not always the case. The diagnostic value of PET is yet a matter of debate. We present a very rare case of a paraganglioma arising at the renal hilum, splaying the renal artery and vein and causing vascular compromise to the left kidney. The patient presented with an atypical presentation of unrelenting fever that was followed by acute colicky pain. Based on imaging and blood metanephrine levels, the diagnosis of paraganglioma was made. Resection of the tumor was achieved and the patient is now asymptomatic.

Keywords: Renal, Hilar, Paraganglioma, Pheochromocytoma, Imaging

Core tip: Chromaffin cell tumors are very rare tumors, the majority of which derive from catecholamine secreting cells in the adrenal glands. Extra-adrenal paragangliomas comprise around 15% of chromaffin cell tumors; they usually arise from sympathetic paraganglia throughout the body. We present a very rare case with the location and presentation of a paraganglioma arising at the renal hilum splaying the renal artery and vein and causing vascular compromise to the left kidney.