Case Report
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World J Gastrointest Surg. Mar 27, 2013; 5(3): 62-67
Published online Mar 27, 2013. doi: 10.4240/wjgs.v5.i3.62
Mesenteric paraganglioma: Report of a case
Takeshi Fujita, Kinji Kamiya, Yoshiaki Takahashi, Shinichiro Miyazaki, Ichirota Iino, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Manabu Ohta, Satoshi Baba, Hiroyuki Konno
Takeshi Fujita, Kinji Kamiya, Yoshiaki Takahashi, Shinichiro Miyazaki, Ichirota Iino, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Manabu Ohta, Hiroyuki Konno, Second Department of Surgery, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
Satoshi Baba, Department of Diagnostic Pathology, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
Author contributions: All authors contributed equally to this work.
Correspondence to: Kinji Kamiya, MD, Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashiku-ku, Hamamatsu-shi, Shizuoka 431-3192, Japan. kamikin@hama-med.ac.jp
Telephone: +81-53-435-2279 Fax:+81-53-435-2273
Received: June 27, 2012
Revised: September 24, 2012
Accepted: December 20, 2012
Published online: March 27, 2013
Abstract

We report a rare case of paraganglioma that developed in the mesentery of terminal ileum. A 78-year-old woman complained of right-sided abdominal pain. Abdominal computed tomography revealed a solid heterogeneously enhanced mass in the right lower abdomen. The tumor was laparoscopically excised. The mesenteric tumor was well circumscribed, ovoid, and encapsulated and measured 3 cm × 1.5 cm × 1.5 cm. Histological examination showed a cellular neoplasm comprised of nests and groups of tumor cells separated by fibrovascular connective tissue, giving a characteristic nested Zellballen pattern. Immunohistochemically, the tumor cells were positive for chromogranin, synaptophysin, CD56, and vimentin and negative for cytokeratins, SMA, CD34, CD117/c-kit and S100. On the basis of histologic and immunohistochemical features, a diagnosis of mesenteric paraganglioma was made. The operative and postoperative courses were unremarkable, and the patient was discharged on postoperative day 7. She was doing well 1 year after the surgery with no signs of recurrence. Extra-adrenal paragangliomas most commonly develop adjacent to the aorta, particularly the area corresponding to the organ of Zuckerkandl. Mesenteric paraganglioma, as in our case, is extremely rare; only 11 cases have been reported in the literature. We herein discuss the clinical findings of these cases.

Keywords: Mesenteric tumor; Extra-adrenal paraganglioma; Pheochromocytoma; Surgical management; Preoperative diagnosis