ULTRASONIC AND COMPUTED TOMOGRAPHIC APPEARANCES OF PARAGANGLIOMA SIMULATING OVARIAN CANCER

Abstract

Paragangliomas or extra-adrenal pheochromocytomas are rare tumors affecting about 1/2000000 of the population’. They originate in paraganglia cells lying adjacent to the ganglia and plexuses of the autonomic nervous systems. Most of them arise from the sympathetic chain between the origin of the renal arteries and the aortic bifurcation. There is an association of paragangliomas with Von Hippel Lindau disease, neurofibromatosis and multiple endocrine neoplasia type Ila and IIb².

Paragangliomas usually present with large solid mass located just adjacent to the aorta in the middle age group. Sometimes, central necrosis is found. Mortality rate for surgery in the unsuspected cases is up to 50%. We report a case of an unusually large cystic paraganglioma in the left pelvis simulating an ovarian cancer. Misdiagnosis led to intra-operative hypertensive crisis and post-operative shock. These crises could have been avoided if we had searched for functional activity pre-operatively.