1736 | Pictorial

Remission of a Renal Artery Stenosis after Laparoscopic Re-
moval of an Extra Adrenal Paraganglioma
Augustin Pirvu, Sebastien Guigard, Philippe Chaffanjon

Corresponding Author:

Augustin Pirvu, MD
Département de Chirurgie Tho-
racique et Endocrinienne, CHU de 
Grenoble, BP 217, Grenoble Cedex 09, 
38043 France.

Tel: +33 476 7693 11
Fax: +33 476 7651 08

E-mail: pb_augustin@yahoo.
com;apirvu@chu-grenoble.fr

Received May 2013
Accepted April 2014

Department of Thoracic and 

Endocrine Surgery, University 

Hospital of Grenoble, Grenoble, 

France. 

A 44-year-old hypertensive man was referred to our department for an infradiaphragmatic right-sided suprarenal mass. Biological examinations were compatible with a pheochromocytoma. A computed tomography (CT) scan revealed a 28 × 23 mm mass located upper an ipsilateral renal artery stenosis 
(Figure 1). The tumor was resected by a laparoscopic transperitoneal approach. On histopathological examination the diagnosis 
of extra adrenal paraganglioma was confirmed. 
The postoperative course was uneventful. One month later, the control CT scan demonstrated complete restoration of the di-
ameter of the right renal artery (Figure 2).
The association between pheochromocytoma and a renal artery stenosis is a rare condition.(1,2) 

If stenosis is mainly due to a local compression by the tumor, in a few cases it can only be explained by the mechanism of an 
arterial vasospasm due to the local catecholamine secretion. 
In the treatment sequences, in order to avoid the therapeutic pitfalls, a high degree of suspicion is necessary.(1-3) In the case of 
simultaneous occurrence of pheochrocytoma and renal artery stenosis, the surgical resection of the tumor must be performed 
in the first step because the renal artery stenosis may regress spontaneously after surgery. Endovascular or open surgical revas-
cularization for the renal artery stenosis is reserved only for persistent or recurrent stenosis.(3) 

PICTORIAL

Figure 1. A computed tomography scan 
shows a 28 × 23 mm mass located upper an 
ipsilateral renal artery stenosis.

Figure 2. One month later, the control 
computed tomography scan demonstrates 
complete restoration of the diameter of the 
right renal artery

REFERENCES

1. Vaze D, Trehan A, Saxena A, Joshi K, Narasimhan KL. Extraadrenal pheochromocytoma with renal artery 
"pseudostenosis"-an important pitfall. Urology. 2012;80:925-7.

2. Gill IS, Meraney AM, Bravo EL, Novick AC. Pheochromocytoma coexisting with renal artery lesions. J Urol. 
2000;164:296-301.

3. Chandra V, Thompson GB, Bower TC, Taler SJ. Renal artery stenosis and a functioning hilar paraganglioma: a 
rare cause of renovascular hypertension--a case report. Vasc Endovascular Surg. 2004;38:385-90.