Case report: A 32-years old female with abdominal right flank mass, high arterial
blood pressure, flushing, pain and diarrhea. She underwent previous unsuccessful
attempt of resection of retroperitoneal tumor. Serum norepinephrine elevated.
CT-scan showed retroperitoneal mass and the angio-MRI showed compression
of inferior vena cava. Octreoscan was positive. Medical treatment showed no response.
Surgical resection was performed after the preoperative medication with
alpha1-bloc. Histopathologic analysis confirmed paraganglioma with uncertain
standard of malignancy. Paragangliomas are rare tumors usually affecting
children and young adults. The diagnosis of malignancy is difficult, ranging on
15-35%. The CT scan common finding is a large heterogeneous mass. Angio-
-MRI may helps to determine great vessels invasion. Catecholamine synthesis
is a feature of this tumor and may cause symptoms. Adequate preoperative
preparation is essential. The clinical and radiological findings may suggest the
diagnosis and the first line therapy is surgery, even if it involves large resections.