A large mesenteric paraganglioma with lymphovascular invasion.

Mesenteric paraganglioma is a rare tumour with only 17 known published case reports so far. This is the second case that demonstrates lymphovascular invasion of the tumour and the third that exhibits its malignant potential. We present a case of a 69-year-old woman with a large palpable abdominal mass that was thought to arise from the ovary following a staging CT scan. Intraoperatively, a large ovoid mass measuring 18 cm×15 cm ×11.5 cm was found on the small bowel mesentery. Histological examination revealed the characteristic Zellbalen pattern with lymphovascular involvement. Mesenteric paraganglioma is rare and remains a diagnostic dilemma. Although the majority of paragangliomas are non-functional and do not show any malignant potential, individual case-based management is needed in view of their unpredictable nature. A multidisciplinary approach with genetic counselling and long-term follow-up are usually necessary to monitor for future disease recurrence. 2015 BMJ Publishing Group Ltd.