Open AccessA rare presentation of clinically intractable hypertension: Pancreatic paraganglioma
Author(s) -
Tseng ChaoMing,
Tsai JenWei,
Tai ChiMing,
Chang ChiYang,
Tang TaoQian,
Wang HsiuPo
Publication year - 2016
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1016/j.aidm.2016.02.001
Subject(s) - paraganglioma , medicine , pheochromocytoma , norepinephrine , pancreaticoduodenectomy , vanillylmandelic acid , radiology , pancreas , pathology , homovanillic acid , receptor , serotonin , dopamine
Summary Paraganglioma is a rare extra‐adrenal pheochromocytoma which originates from chromaffin cells within the ganglia of the sympathetic trunk and of the celiac, renal, suprarenal, and hypogastric plexuses. Pancreatic paragangliomas are rarer still. And even then, paragangliomas are mostly reported to be nonfunctional. We report a case of a 64‐year‐old woman with underlying disease of hypertension who presented with biliary colic. Contrast‐enhanced computer tomography showed an enhancing mass in the uncinate process of the pancreas. Pylorus‐sparing Whipple procedure was performed for complete tumor excision. Hypertensive crisis developed after Whipple, which improved after continuous intravenous nicardipine infusion. Pathology revealed a paraganglioma. A 24‐h catecholamine urine test showed increased norepinephrine and vanillylmandelic acid level. Functional paraganglioma was diagnosed.