A rare case of cardiac paraganglioma presenting as anginal pain: a case report

Abstract

IntroductionPrimary cardiac paraganglioma is a very rare tumor with less than sixty reported cases in the literature. The clinical presentation is variable, but is most commonly manifested by hypertension and symptoms related to the catecholamine excess.Case ReportWe report a case of a 35 year old man who presented with anginal pain and hypertension. He was found to have a cardiac mass on the computed tomographic scan and echocardiogram. He underwent surgical exploration of the mass which on biopsy was found to be a 'Cardiac Paraganglioma'. Surgical resection of the tumor was successfully done and the patient is doing well five years after the surgery without any evidence of recurrence. His blood pressure, however, failed to normalize and needed single agent antihypertensive therapy.ConclusionCardiac paragangliomas have a relatively favorable outcome if diagnosed and resected in time. We briefly review the literature regarding the diagnosis, treatment and prognosis of this rare tumor.

Surgical excision with left atrial reconstruction of a primary functioning retrocardiac paraganglioma

“…Clinical presentation depends on the functional status of the paraganglioma and the location at the heart: paroxysmal hypertension due to secretion of catecholamines, chest pain [15], symptoms secondary to pericardial involvement or invasion of the conduction system [16] or inespecified symptoms such as fever or malaise. In cases of extension to valves, other primary cardiac tumors such as mixoma or angiosarcoma must be excluded.…”

Cardiac Paraganglioma, Recent Advances in Clinicopathologic Features

“…Symptoms related to local tumor effects depend on the size and anatomical location of the tumor. These include heart failure, mitral insufficiency, embolization, and ischemic heart disease-like symptoms [4]. Constitutional symptoms not related to secretory profiles or local effects include weight loss, fatigue, and fever [3].…”

“…Commonly used modalities include contrastenhanced computed tomography (CT) scan, dedicated cardiac magnetic resonance imaging (MRI), transthoracic echocardiogram (TTE), and coronary arteriography [23]. By echocardiography, cardiac PGs appear as large, echogenic masses [4]. CT scan will show heterogeneous mass with peripheral enhancement and low attenuation areas due to tumor degeneration and necrosis [24].…”