Paraganglioma in the posterior mediastinum: a case report

Abstract

Background Paragangliomas are tumors that arise from extra-adrenal chromaffin cells. Herein, we present a rare case of a functional paraganglioma in the posterior mediastinum. Case presentation A 36-year-old man presented with paroxysms of chest pain and headache. At presentation, the patient’s blood pressure was 190/120 mmHg. Chest computed tomography and magnetic resonance imaging revealed a left paravertebral mass in the posterior mediastinum. 123I-metaiodobenzylguanidine scanning revealed focally high tracer uptake in the left paravertebral area. The metanephrine level in the urine was elevated, confirming a rare, catecholamine-producing, functional paraganglioma in the posterior mediastinum. Before surgery, the patient was prepared by orally administering α- and β-adrenergic blockers. The mass was then resected via a lateral thoracotomy. The metanephrine level in urine was normal 24 h after surgery. Conclusions Paragangliomas in the posterior mediastinum are very rare, but more than half of all cases are functional. The associated symptoms are curable with complete resection, and long-term follow-up for recurrence is important.

A young patient with heart failure was diagnosed with extra-adrenal paraganglioma: a case report

“…Ultrasound, computed tomography, magnetic resonance imaging, 123 I-MIBG and PET-CT are invaluable in locational diagnosis of paraganglionoma. In particular, 123 I-MIBG has the highest specificity (95-100%) because it is an epinephrine analogue and can be absorbed by pheochromocyte catecholamine vesicles [8]. In this case, the lesion was detected on pelvic ultrasound.…”

Paraganglioma of the anterior superior mediastinum: Presentation of a case of mistaken diagnosis so long and review of the literature

“…When necessary, oncologists and radiologists should consult with each other to provide comprehensive postoperative care. Generally, relevant symptoms can be relieved after surgery [18] , [19] , [20] .…”

Neurogenic tumours of the posterior mediastinum and differential diagnosis considerations

“…Paraganglioma in the posterior mediastinum is more frequently functional than those in other compartments of the mediastinum, with secretion of catecholamines, or rarely other substances, which will often, but not invariably, cause systemic symptoms. [39][40][41][42] These tumours may grow to reach a large size, which may result in nonfunctional symptoms owing to their space-occupying properties. 43 Paraganglioma is associated with inherited cancer syndromes in 25-50% of cases.…”