RESUMO
This report describes the case of a 60-year-old woman with a history of hysterectomy for myomas, totally asymptomatic, with incidental evidence of a pelvic intracaval mass extending to the right atrium. She underwent a staged procedure (sternothomic and abdominal) through a thoracolaparotomic approach in circulatory arrest and deep hypothermia. Using a one-stage surgical approach, we were able to withdraw one portion of the mass from the right atrium and another from the abdominal inferior vena cava, thus minimizing the risk of unexpected venous or atrial wall injury during surgical manipulation.
Assuntos
Veia Ilíaca/cirurgia , Leiomiomatose/cirurgia , Procedimentos Cirúrgicos Torácicos , Neoplasias Uterinas/cirurgia , Veia Cava Inferior/cirurgia , Biópsia , Ponte Cardiopulmonar , Parada Circulatória Induzida por Hipotermia Profunda , Feminino , Átrios do Coração/patologia , Átrios do Coração/cirurgia , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/patologia , Achados Incidentais , Leiomiomatose/diagnóstico por imagem , Leiomiomatose/patologia , Pessoa de Meia-Idade , Invasividade Neoplásica , Esternotomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Neoplasias Uterinas/patologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologiaRESUMO
After the incidental intraoperative discovery of a paraganglioma of cranial nerve XII, we searched our hospital database and literature for similar cases to determine whether evidence exists to support the existence of paraganglioma of the hypoglossal nerve. We describe a case of cranial nerve XII paraganglioma, recognized only during surgery, without any indicative preoperative sign or symptom nor diagnostic imaging studies. In light of published findings, only four cases described since 1966, and our experience, the report discusses diagnostic criteria that could aid in establishing a diagnosis of hypoglossal nerve paraganglioma based on a reasonable degree of medical certainty.
