A case of paragangloma near the left adrenal gland associated with total situs inversus.

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  • 完全内臓逆位症に合併した左副腎近傍パラガングリオーマの１例

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Abstract

We encountered a patient with paraganglioma near the left adrenal gland associated with total situs inversus. A 74-year-old woman was referred to the department because of a tumor in contact with the left adrenal gland and situs inversus accidentally detected by abdominal ultrasonography (US). Abdominal US, CT, and magnetic resonance imaging revealed total situs inversus and a well-delineated tumor 3 cm in diameter, cranial to the left kidney and medial to the posterior segment of the liver. The blood and urinary catecholamine levels were abnormally high, and MIBG scintigraphy showed accumulation in the region of the left adrenal gland. With a tentative diagnosis of pheochromocytoma in the left adrenal gland, the tumor was resected. Surgical findings included left-sided liver, right-sided stomach, total situs inversus, and a hard tumor, 5 cm in diameter, cranial to the left renal vein. Histopathologically, the tumor was diagnosed as paraganglioma originating in the retroperitoneum near the adrenal gland based on clear borders between the tumor and adrenal tissue. The catecholamine levels were normalized after the operation. No signs of recurrence have been observed as of 9 months after the operation. There have been no case reports of paraganglioma with total situs inversus in the Japanese literature.

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