Paraganglioma in the renal pelvis

Paraganglioma is a rare tumor originating from the primitive neural crest, and can develop at many locations, such as the abdomen, aortic bifurcation, neck, pelvis, and thorax. However, the renal pelvis is an extremely rare location for paragangliomas to occur. Here, we report a case initially suspected to be a renal mass in a 59-year-old patient with paroxysmal hypertension, heart palpitation, and sweating. However, the mass was pathologically confirmed to be a paraganglioma in the renal pelvis. This report describes its rarity as well as its clinical and therapeutic characteristics. The patient, a 59-year-old Chinesewoman, had a 2-month history of paroxysmal hypertension, heart palpitation, and sweating. Her blood pressure measured 137/77 mmHg, and the remainingphysical examination resultswerenormalupon admission. Her blood metanephrine and normetanephrine levels were 322 ng/L and 632 ng/L, respectively, and other laboratory test results were normal. The left renal mass, measuring 4 cm in diameter, was detected by a computed tomographic (CT) scan without border differentiation, and enhanced CT results showed images of enhanced kidney only but not the mass. It was difficult, however, to determine the origin of the mass. The patient then underwent a preoperative preparationwith a and b blockers for 2weeks. During the surgery, we determined that both the mass and the left kidney had the same origin; therefore, radical excision of the left kidney and the tumor was performed. Paraganglioma in the renal pelvis was diagnosed pathologically, with Pan Cytokeratin (PCK) being negative, whereas synaptophysin, chromogranin A, and S-100 were positive immunohistochemically (Fig. 1). The patient’s postoperative recovery waswithout complications. During 3months of follow-up, her