Transabdominal Intrapericardial Approach in Liver Transplantation for Unresectable Primary Hepatic Functioning Paraganglioma With Invasion Into Hepatic Veins and Suprahepatic Vena Cava: A Surgical and Anesthesia Management Challenge. Transplant Proc 2018 Nov;50(9):2630-2635
Date
11/08/2018Pubmed ID
30401364DOI
10.1016/j.transproceed.2018.02.189Scopus ID
2-s2.0-85055872814 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
Primary hepatic functional paraganglioma is a rare form of extra-adrenal catecholamine-secreting tumor. Definitive treatment of functioning paraganglioma is challenging because of the critical location of the tumor frequently in close proximity to vital structures and risk of excessive catecholamine release during operative manipulation. We report the multidisciplinary management approach for a case of unresectable primary hepatic functional paraganglioma with invasion into the hepatic veins and suprahepatic vena cava. To our knowledge, this is the first report showing that orthotopic liver transplantation is curative for patients with unresectable primary hepatic paraganglioma. For locally advanced unresectable hepatic paraganglioma that involves the intrapericardial vena cava, a meticulous pre- and intraoperative medical management and transabdominal intrapericardial vascular control of the suprahepatic vena cava during orthotopic liver transplantation allows for complete extirpation of the tumor and achieves optimal outcome.
Author List
Kim J, Fons RA, Scott JP, Eriksen CM, Lerret SM, Browning MB, Telega GW, Vitola BE, Hoffman GM, North PE, Vo NN, Zimmerman MA, Hong JCAuthors
Calvin Martin Eriksen MD Assistant Professor in the Surgery department at Medical College of WisconsinRoger A. Fons MD Adjunct Assistant Professor in the Anesthesiology department at Medical College of Wisconsin
George M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
Stacee Lerret PhD Professor in the Pediatrics department at Medical College of Wisconsin
Paula E. North MD, PhD Professor in the Pathology department at Medical College of Wisconsin
John P. Scott MD Professor in the Anesthesiology department at Medical College of Wisconsin
Grzegorz W. Telega MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abdominal WallAdolescent
Hepatic Veins
Humans
Liver Neoplasms
Liver Transplantation
Male
Neoplasm Invasiveness
Paraganglioma
Pericardium
Venae Cavae
