{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:49:19Z","timestamp":1765370959842,"version":"3.46.0"},"reference-count":15,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Gastroenterol"],"abstract":"<jats:p>&lt;p&gt;Introduction: Paraganglioma is an extra-adrenal pheochromocytoma that requires surgical resection with strict perioperative management because of its catecholamine-producing nature. We report a case of successful laparoscopic resection of a large retroperitoneal paraganglioma in an older patient. Case Presentation: An 80-year-old man was diagnosed with hypertension during a routine health checkup. Elevated plasma metanephrine and normetanephrine levels, along with radiological findings of a 6.5-cm tumor with 123I-metaiodobenzylguanidine accumulation anterior to the aorta, confirmed the diagnosis of retroperitoneal paraganglioma. Surgical resection was planned accordingly. Preoperative optimization with a selective \u03b11 blocker was conducted over 2 months, and intravenous saline infusion was administered the day before surgery. Laparoscopic exploration revealed a tumor on the dorsal side of the small bowel mesentery, extending dorsally and caudally to the third portion of the duodenum. En bloc resection was performed using a six-port approach. Intraoperatively, systolic blood pressure transiently spiked to 170 mm Hg during tumor manipulation but was controlled with an intravenous bolus of phentolamine mesylate. Post-resection hypotension was effectively prevented by the continuous infusion of low-dose noradrenaline. Postoperatively, the blood pressure remained well controlled without medication, and no surgical complications occurred. Histopathological examination confirmed the diagnosis of a paraganglioma. Conclusion: This case highlights the importance of precise diagnosis, meticulous perioperative planning and management, and minimally invasive surgery in the successful treatment of large retroperitoneal paragangliomas in older patients. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000547732","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:11:45Z","timestamp":1765357905000},"page":"644-652","source":"Crossref","is-referenced-by-count":0,"title":["Totally Laparoscopic Resection of a Large Retroperitoneal Paraganglioma in an Older Patient: A Case Report on Precise Diagnosis and Perioperative Management"],"prefix":"10.1159","volume":"19","author":[{"given":"Kenichiro","family":"Yambe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8554-3869","authenticated-orcid":false,"given":"Shingo","family":"Tsujinaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoya","family":"Miura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Nakano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chikashi","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Katayose","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1129622"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvaf024"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.19019"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1174836"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-020-00732-0"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/iju5.12097"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2017.0056"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9941.169990"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.586503"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149433"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1530\/EC-21-0539"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz188"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-03072-z"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003596"}],"container-title":["Case Reports in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000547732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:11:48Z","timestamp":1765357908000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000547732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000547732","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.29673641","asserted-by":"subject"}]},"ISSN":["1662-0631"],"issn-type":[{"value":"1662-0631","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}