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Case report
- Interleukin-6-producing paraganglioma as a rare cause of systemic inflammatory response syndrome: a case report
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Yin Young Lee, Seung Min Chung
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J Yeungnam Med Sci. 2023;40(4):435-441. Published online March 7, 2023
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DOI: https://doi.org/10.12701/jyms.2022.00766
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Abstract
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- Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient’s body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient’s inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.
Case Report
- A Case of Nonfunctioning Paraganglioma of the Posterior Mediastinum.
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Young Chul Mun, Sung Keun Yu, Hye Jung Park, Kyeong Cheol Shin, Choong Ki Lee, Jin Hong Chung, Kwan Ho Lee, Mee Jin Kim, Jung Cheul Lee
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Yeungnam Univ J Med. 2000;17(2):155-160. Published online December 31, 2000
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DOI: https://doi.org/10.12701/yujm.2000.17.2.155
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Abstract
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- Paraganglioma is a tumor from the extra adrenal paraganglion system and is rarely observed in the mediastinum. The authors experienced a case of nonfunctioning paraganglioma of the posterior mediastinum. The patient was 34-years-old male in whom abnormal mass lesion was nites in chest radiograph with hemoptysis. His blood pressure and serologic examination were within normal range upon admission to our hospital. Chest CT revealed a tumor in the left lower lobe. Diagnostic thoracoscopy was performed and diagnosed a posterior mediastinal mass. Surgical resection was them performed. Posterior mediastinal mass was removed successfully and histological examination of the surgical specimen diagnosed paraganglioma. He received radiotherapy after surgery and was followed up. Related literature are reviewed.