Haemorrhagic Retroperitoneal Paraganglioma: A Report of a Rare Case

Catecholamine-producing tumours are rare entities that, even though their clinical diagnostic might be a challenge due to the non-specificity of the symptoms, have had a growing incidence due to the continuous improvement of medical imaging examinations and the evolution of molecular genetic testing. On the other hand, they can rarely manifest as serious complications, such as myocardial infarction, stroke, or alveolar haemorrhage. This paper describes the case of a 77-year-old Caucasian man who presented with acute onset of left upper quadrant abdominal pain. The first abdominal computed tomography (CT) scan showed an active haemorrhage originating from a retroperitoneal paraganglioma. The patient received intravenous fluids and prothrombin complex concentrate for reversal of anticoagulation therapy. A reassessment CT scan performed 12 hours later suggested increased bleeding, and laboratory findings showed a worsening of the anemia, so an angiography was performed which didn't show any evidence of haemorrhage. After a multidisciplinary discussion, it was decided to admit the patient for surveillance and imaging evaluation. Six days later, a second reassessment CT showed signs of haemorrhagic resolution, and the patient was discharged with subsequent follow-up in the outpatient clinic. The authors highlight this case for being a rare complication of an equally rare neuroendocrine tumour.