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Case Reports in Endocrinology
Volume 2012, Article ID 481328, 5 pages
http://dx.doi.org/10.1155/2012/481328
Case Report

Preoperative Embolization Reduces the Risk of Cathecolamines Release at the Time of Surgical Excision of Large Pelvic Extra-Adrenal Sympathetic Paraganglioma

1Department of Internal Medicine, Rome Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy
2Department of Radiology, Rome Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy
3Department of Nuclear Medicine, Rome Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy
4Department of Surgery, Rome Tor Vergata University, Viale Oxford 81, 00133 Rome, Italy

Received 14 May 2012; Accepted 1 August 2012

Academic Editors: C. Capella and A. Sahdev

Copyright © 2012 Nicola Di Daniele et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 30-year-old woman with severe hypertension was admitted to the hospital with a history of headache, palpitations, and diaphoresis following sexual intercourse. Twenty-four hour urinary excretion of free catecholamines and metabolites was markedly increased as was serum chromogranin A. Computed tomography scan revealed a large mass in the left adnex site and magnetic resonance imaging confirmed the computer tomography finding, suggesting the presence of extra-adrenal sympathetic paraganglioma. I-metaiodobenzyl guanidine scintigram revealed an increased uptake in the same area. Transcatheter arterial embolization of the mass resulted in marked decreases in blood pressure and urinary excretion of free catecholamines and metabolites. Surgical excision of the mass was then accomplished without complication. Preoperative embolization is a useful and safe procedure which may reduce the risk of catecholamines release at the time of surgical excision in large pelvic extra-adrenal sympathetic paraganglioma.