Mattia Garancini, Giovanni Cesana, Camillo Di Bella, Antonio Tancredi, Adelio Valtorta, Maria Enrica Giovenzana and Massimo Beltramo
Paragangliomas are a type of neuroendocrine tumor derived from embryonic neural crest. They are mostly found in the adrenal glands (pheocromocytomas) and in the extra-adrenal paraganglia of the autonomic nervous system (extra-adrenal paraganglioma). Paragangliomas arising from the kidney or in the renal hilus are very rare and a preoperative diagnosis is hardly made. We present the case of a 44-years-old female with a 1-week history of feeling a mass in the right-upper side of the abdomen and no other symptoms. Computerized tomography (CT) demonstrated a round solid extra-adrenal mass located at the renal hilus. Laparotomy was performed with the intention of removing the mass and providing a histopathological diagnosis. Microscopic examination revealed a characteristic “Zellballen” organization and the presence of Sustentacular Cells S-100 positive. On these findings, extra-adrenal paraganglioma of the renal hilus was diagnosed histologically. The patient did not receive any further treatment other than surgery. The intervention was safe and effective. On a 20 months follow-up she results healthy and disease-free.