An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature
Introduction. A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for...
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2023-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2023/6637802 |
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| author | Elizabeth Eberechi Oyenusi Uzoamaka Felicia Nwigbo Oluwadamilola Moromoke Oladipo Blessing Ebele Kene-Udemezue Kasarachi Pauline Akowundu Khadijah Omobusola Oleolo-Ayodeji Oluwaseun Adunni Afoke Funmilayo Oluwatoyin Babatunde Felix Makinde Alakaloko Gabriel Kolawole Asiyanbi Ezekiel Olayiwola Ogunleye Abiola Olufunmilayo Oduwole Foluso Ebun Afolabi Lesi |
| author_facet | Elizabeth Eberechi Oyenusi Uzoamaka Felicia Nwigbo Oluwadamilola Moromoke Oladipo Blessing Ebele Kene-Udemezue Kasarachi Pauline Akowundu Khadijah Omobusola Oleolo-Ayodeji Oluwaseun Adunni Afoke Funmilayo Oluwatoyin Babatunde Felix Makinde Alakaloko Gabriel Kolawole Asiyanbi Ezekiel Olayiwola Ogunleye Abiola Olufunmilayo Oduwole Foluso Ebun Afolabi Lesi |
| author_sort | Elizabeth Eberechi Oyenusi |
| collection | DOAJ |
| description | Introduction. A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for prompt diagnosis and treatment. Case Description. A 14-year-old girl was referred to the paediatric neurology unit for recurrent headaches of one-year duration, vomiting of 2 months duration, and an episode of generalized tonic-clonic seizures, 2 weeks prior to presentation. There was an associated history of impaired vision, palpitations, diaphoresis, and easy fatigability. Her blood pressure ranged from 150/101 to 160/120 mmHg. The brain CT scan was normal. ECG showed left ventricular hypertrophy. Abdominal USS revealed a right para-aortic mass necessitating 24-hour urine normetanephrine which was markedly elevated–1695.34 mcg/24 h (100–500). An abdominal CT scan confirmed a paraganglioma in the right para-aortic region. A multidisciplinary team consisting of paediatric endocrinologists, radiologists, anaesthetists, paediatric and cardiothoracic surgeons, and the intensive care unit (ICU) team was involved in the peri and postoperative management of the child. Intraoperative challenges were hypertension and hypotension (following tumour excision). She was nursed in the ICU for 48 hours. Histology results confirmed paraganglioma. Postoperative urine normetanephrines done a month after surgery had reverted to normal. Her blood pressure has remained normal 6 months after surgery, and no other symptoms have recurred. Conclusion. In evaluating aetiology of childhood hypertension, endocrine causes must be considered though they are rare. The occurrence of paraganglioma is uncommon and can present in unusual ways such as seizures. Measurement of blood pressure in children is advocated as part of routine health care. Clinicians must explore the aetiology of seizures and not merely control them with anticonvulsant therapy. |
| format | Article |
| id | doaj-art-641b7d3ebeca445f8051abb1c44b4101 |
| institution | Kabale University |
| issn | 2090-651X |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-641b7d3ebeca445f8051abb1c44b41012025-02-03T01:29:34ZengWileyCase Reports in Endocrinology2090-651X2023-01-01202310.1155/2023/6637802An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the LiteratureElizabeth Eberechi Oyenusi0Uzoamaka Felicia Nwigbo1Oluwadamilola Moromoke Oladipo2Blessing Ebele Kene-Udemezue3Kasarachi Pauline Akowundu4Khadijah Omobusola Oleolo-Ayodeji5Oluwaseun Adunni Afoke6Funmilayo Oluwatoyin Babatunde7Felix Makinde Alakaloko8Gabriel Kolawole Asiyanbi9Ezekiel Olayiwola Ogunleye10Abiola Olufunmilayo Oduwole11Foluso Ebun Afolabi Lesi12Endocrinology and Metabolism UnitDepartment of PaediatricsDepartment of PaediatricsDepartment of PaediatricsDepartment of PaediatricsDepartment of PaediatricsDepartment of RadiodiagnosisDepartment of PaediatricsPaediatric Surgery UnitDepartment of AnaesthesiaCardiothoracic UnitEndocrinology and Metabolism UnitNeurology UnitIntroduction. A paraganglioma (PGL) is a tumour derived from extra-adrenal chromaffin cells of the sympathetic paravertebral ganglia of the thorax, abdomen, and pelvis. Cardiovascular manifestations predominate but neurological symptoms like seizures can occur requiring a high index of suspicion for prompt diagnosis and treatment. Case Description. A 14-year-old girl was referred to the paediatric neurology unit for recurrent headaches of one-year duration, vomiting of 2 months duration, and an episode of generalized tonic-clonic seizures, 2 weeks prior to presentation. There was an associated history of impaired vision, palpitations, diaphoresis, and easy fatigability. Her blood pressure ranged from 150/101 to 160/120 mmHg. The brain CT scan was normal. ECG showed left ventricular hypertrophy. Abdominal USS revealed a right para-aortic mass necessitating 24-hour urine normetanephrine which was markedly elevated–1695.34 mcg/24 h (100–500). An abdominal CT scan confirmed a paraganglioma in the right para-aortic region. A multidisciplinary team consisting of paediatric endocrinologists, radiologists, anaesthetists, paediatric and cardiothoracic surgeons, and the intensive care unit (ICU) team was involved in the peri and postoperative management of the child. Intraoperative challenges were hypertension and hypotension (following tumour excision). She was nursed in the ICU for 48 hours. Histology results confirmed paraganglioma. Postoperative urine normetanephrines done a month after surgery had reverted to normal. Her blood pressure has remained normal 6 months after surgery, and no other symptoms have recurred. Conclusion. In evaluating aetiology of childhood hypertension, endocrine causes must be considered though they are rare. The occurrence of paraganglioma is uncommon and can present in unusual ways such as seizures. Measurement of blood pressure in children is advocated as part of routine health care. Clinicians must explore the aetiology of seizures and not merely control them with anticonvulsant therapy.http://dx.doi.org/10.1155/2023/6637802 |
| spellingShingle | Elizabeth Eberechi Oyenusi Uzoamaka Felicia Nwigbo Oluwadamilola Moromoke Oladipo Blessing Ebele Kene-Udemezue Kasarachi Pauline Akowundu Khadijah Omobusola Oleolo-Ayodeji Oluwaseun Adunni Afoke Funmilayo Oluwatoyin Babatunde Felix Makinde Alakaloko Gabriel Kolawole Asiyanbi Ezekiel Olayiwola Ogunleye Abiola Olufunmilayo Oduwole Foluso Ebun Afolabi Lesi An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature Case Reports in Endocrinology |
| title | An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature |
| title_full | An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature |
| title_fullStr | An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature |
| title_full_unstemmed | An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature |
| title_short | An Atypical Presentation of Childhood Paraganglioma with Seizures: A Case Report and Review of the Literature |
| title_sort | atypical presentation of childhood paraganglioma with seizures a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2023/6637802 |
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