Mediastinal paraganglioma irrigated by coronary vessels in a patient with an atypical chest pain

Abstract

We present a case of non-functioning anterior mediastinal paraganglioma in a 61-year-old woman. The tumour was accidentally discovered on a coronary angiography performed in an atypical precordial pain and dyspnea. The coronary angiography showed a vascular tumour in the paraaortic localization irrigated from two branches of coronary arteries. Diagnosis was confirmed by a thoracic tomographic scan which revealed an anterior mediastinal tumour. Complete tumour resection was done through a sternotomy with extracorporeal circulation without cardiac arrest. The histological examination of the operative specimen was characteristic of paraganglioma.

Black cardiac paraganglioma in a multiple paraganglioma syndrome

“…Intraoperative diagnosis was helped by manipulation of the mass and delivery of cardioplegia which caused tremendous hypertensive crises and that increased the doubt of neuroendocrine origin. Radical surgical resection is usually the treatment of choice [5], even with reconstructive surgery [6], but unfortunately our excision was not radical because the mass, despite not infiltrating, was locally very invasive. Transplantation was not indicated due to age (69 years old, HCV+), which is an alternative when total resection is not possible [7].…”

Intrapericardial Paraganglioma Directly Irrigated by the Right Coronary Artery

“…The other group is chemodectomas, which are noncatecholamine‐secreting tumors that may present with symptoms and signs due to local pressure or invasion. The commonest site for this tumor is the carotid body 1 …”

“…They can be found throughout the body mainly in the adrenal medulla, along the aorta and in walls of blood vessels, and they have been reported in the heart, prostate, ovary, and intestine. They rarely become malignant 1,2 …”