Abstract
A case is reported in which a 46-year-oldnormotensive male patient presented with largeright-sided painless abdominal mass. Onsonography there was a large cyst in the lowerpole of right kidney. Intravenous urographyshowed distortion of pelvicollecting system and medial shift of upper right ureter.Exploration revealed a cystic mass (18 × 15 cm) located in lower pole of right kidney. Itcontained brownish fluid and because of suspicion of malignancy radical nephrectomy wascarried out. Histological examination showed the cystic mass to be adrenal tissueinfiltrated by neoplastic cells. Characteristicorganoid nests of malignant cells (``Zellaballen'' were present. Cells stained positively for chromogranin, neurone specific enolase (NSE),neurofilament, and synaptophysin. Sustentacular cells showed positive reaction toS-100 protein. No further treatment was offered. Patient remains well at 30 monthsfollow-up. On medline search there is record of three cases of intra-renal paraganglioma inEnglish literature and the present case appears to be the fourth one.
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References
Lacks EE, Cubilla AL, Woodruff JM, Lieberman PH. Extraadrenal paragangliomas of the retroperitoneum: A clinicopathologic study of 12 tumors. Am J Surg Path 1980; 4(2): 109–120.
Bennington JL, Beckwith JB (eds.). Atlas of Tumor Pathology. Second series, fascicle 12. Tumors of the Kidney, Renal Pelvis and Ureter, p15. Armed forces institute of Pathology, Washington Publishers, 1975.
Rossi G, Oleari G, Botti C, Torricelli P, Baccarini P, Barbolini G. Cystic paraganglioma of the renal capsule. J Urol 2001; 165(2): 511–512.
Whalen RK, Althausen AF, Daniels GH. Extra-adrenal pheochromocytoma. J Urol 1992; 147(1): 1–10.
Wareen WH, Lee I, Gould VE, Memoli VA, Jao W. Paraganglioma of head and Neck. Ultrastructural and immunohistochemical analysis. Ultrastruct Pathol 1985; 8: 333–343.
Juan Rossi. Adrenal gland and other paraganglia. In: Ackerman's Surgical Pathology, 8th edition. Mosby USA, 1996: 1015–1058.
Schroder HD, Jonannsen L. Demonstration of S-100 protein in sustentacular cells of pheochromocytoma and paraganglioma. Histopathology 1986; 10: 1023–1033.
Kliewer KE, Wen DR, Cancilla PA, Chochrane AJ. Paragangliomas: Assessment of prognosis by histologic, immunohistochemical and ultrastructural techniques. Hum Pathol 1989; 20: 29–39.
Linloila RI, Lack EE, Steinberg SM, Keiser HR. Decreased expression of neuropeptidase in malignant paragangliomas: An immunohistochemical study. Hum Pathol 1988; 19: 41–50.
Shah MJ. Karelia NH, Patel SM, Desai NS, Mehta HV, Singh S. Flow cytometric DNA analysis for determination of malignant potential in adrenal pheochromocytoma or paragangliom. An Indian experience. Ann Surg Oncol 2003; 10(4): 426–431.
Favier J, Plouin PF, Corvol P, Gase JM. Angiogenesis and vascular architecture in pheochromocytomas; distinctive traits in malignant tumors. Am J Pathol 2002; 161(4): 1235–1246.
Madrigal Rubiales B, Vara Castrodeza A, Fresno Forcenedo M, Albanedo Albanedo P. Non secreting, extra-adrenal retroperitoneal paragangliomas. Arch Esp Urol 2002; 55(5): 543–547.
Bezirdjian DR, Tegtmeyer CJ, Leef JL. Intrarenal pheochromocytoma and renal artery stenosis. Urol Radiol 1981; 3(2): 121–122.
Preger L, Gardner RE, Kawala BO, Steinbach HL. Intrarenal pheochromocytoma: preoperative angiographic diagnosis. Urology 1976; 8(2): 194–196.
Simon H, Carlson DH, Hanelin J, Kleeman F, Feena D. Intrarenal pheochromocytoma: a report of a case. J Urol 1979; 121(6):805–807.
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Rafique, M., Bhutta, R. & Muzzafar, S. Case report: Intra-renal paraganglioma masquerading as a renal cyst. Int Urol Nephrol 35, 475–478 (2003). https://doi.org/10.1023/B:UROL.0000025630.11610.38
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DOI: https://doi.org/10.1023/B:UROL.0000025630.11610.38