A case of an unexpected posterior mediastinal functional paraganglioma: case report and literature review

Abstract

Background: Paraganglioma can be found in a wide range of locations. However, paraganglioma in the posterior mediastinum is rare. An unexpected paraganglioma located in the posterior mediastinum was found during surgery. The anesthesia management of this patient was challenging. Case presentation: A 65-year-old male with a posterior mediastinal tumor was scheduled for thoracoscopic mediastinal tumor resection. Severe hemodynamic changes during the operation and postoperative pathological diagnosis showed that the patient had a rare case of posterior mediastinal functional paraganglioma, which was not found before the operation. Although the patient did not experience side effects after surgery, he did experience a dangerous surgical process. Conclusions: The correct diagnosis of paraganglioma, intensive preoperative screening, adequate preoperative preparation, and accurate intraoperative anesthesia management could provide better anesthesia for paraganglioma patients.

Middle mediastinal paraganglioma enclosing the left anterior descending artery: A case report

“…Fortunately, majority parents who achieved successful resection have a favorable prognosis. [ 18 – 20 ]…”

Pulmonary artery transection for resection of a middle mediastinal paraganglioma

“…To address these complications, some cases report using preoperative embolization to reduce intraoperative bleeding, 14 , 15 and others report utilizing α‐adrenergic blockade to prevent intraoperative catecholamine crisis. 16 Tumor recurrence following resection is common, with past studies demonstrating local recurrences in 55.7% of cases and metastatic spread in 26.6% of cases. 4 After resection, close follow‐up of patients for evidence of recurrence and metastasis is essential.…”

“…Perioperative morbidity and mortality are typically associated with intraoperative bleeding, due to the high vascularity of these tumors, and catecholamine hypersecretion in cases of functional paragangliomas. To address these complications, some cases report using preoperative embolization to reduce intraoperative bleeding, 14,15 and others report utilizing α‐adrenergic blockade to prevent intraoperative catecholamine crisis 16 4 .…”

Anesthetic Management in Anterior Mediastinal Pheochromocytoma Case

“…The amount of catecholamine that passes into the blood in stimulation of any tumor tissue can reach 1000 times the normal serum level or more [6] . Catecholamine release occurs in 80-85% of patients with paraganglioma and causes severe clinical symptoms [2] . In contrast, only 40% of patients experience paroxysmal hypertension.…”

“…Pheochromocytoma and paraganglioma are rare variations of neuroendocrine tumors arising from the sympathetic chain focus of the adreneal medulla and non-adrenal medulla [1,2] . Paraganglioma can be seen in a wide variety of locations including abdomen (80-85%), pelvis, neck and head (5%) and chest cavity (5%).…”