Rational: Paragangliomas are rare and can occur in many places throughout the body, but mediastinal paragangliomas are even rarer, accounting for less than 0.3% of mediastinal masses. Extremely susceptible to misdiagnosis and mistreatment, which may lead to the death of the patient.
Patient Concerns: We report a case of a giant paraganglioma of the middle mediastinum. A 40-year-old woman was admitted to the hospital with a rib fracture and a chest computed tomography suggesting a giant occupying tumor in the middle mediastinum.
Diagnosis: Immunohistochemistry revealed positive for S100 fraction and Syn, focally positive for CgA, while negative for CKp and succinate dehydrogenase complex iron sulfur subunit B gene, and Ki67index ≈ 5%. The imaging and immunohistochemical features suggested a final diagnosis of Paragangliomas.
Interventions: This patient underwent lateral open heart surgery to remove a mediastinal mass.
Outcomes: One month after being discharged, the patient was contacted by phone for a follow-up visit and reported feeling OK. Unfortunately, as of the date of submission, the patient did not come to our hospital for review.
Lessons: Mediastinal paraganglioma as a rare and potentially malignant tumor susceptible to misdiagnosis and mistreatment. Organ pathology examination is the gold standard for diagnosis, and surgery is an important treatment method. A clear diagnosis and thorough preoperative examination are important guarantees for the success of surgery.
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http://dx.doi.org/10.1097/MD.0000000000036327 | DOI Listing |
Int J Surg Case Rep
January 2025
Department of Thoracic surgery, National University Hospital, Damascus University, Damascus, Syria.
Introduction: Mediastinal paragangliomas are rare neoplasms arising from extra-adrenal neural crest cells, presenting as either functional or nonfunctional tumors. Clinical manifestations range from catecholamine-related symptoms to physical compression effects. Accurate recognition of these tumors is crucial for diagnosis and management due to their rarity and association with vital mediastinal structures.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P. R. China.
Background: Paragangliomas are rare neoplasms arising from extra-adrenal chromaffin cells, with mediastinal paragangliomas representing an exceptionally rare subset. This report details the surgical management of a complex mediastinal paraganglioma case, presenting with refractory hypertension and invasion of critical surrounding structures. A comprehensive review of the current literature is included to underscore existing cases, enhance clinical awareness, and share our insights and experience in the diagnosis and treatment of this challenging condition.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Urology, Gansu Provincial Hospital, Lanzhou, China.
Rationale: Pheochromocytomas typically arise in the adrenal medulla, whereas ectopic pheochromocytomas/paragangliomas commonly occur near the abdominal aorta, bladder, mediastinum, and head. Diaphragmatic pheochromocytomas are exceedingly rare, and there is limited surgical experience with their treatment.
Patient Concerns: In Case A, the subject is a 45-year-old male, while in Case B, the subject is a 59-year-old female.
J Surg Case Rep
December 2024
Department of Thoracic Surgery, Morristown Medical Center, Morristown, NJ 07960, United States.
Paragangliomas are rare neuroendocrine tumors originating from extra-adrenal paraganglia that often require intricate surgical resection. Specifically, when paragangliomas are localized within the thorax and coexist with cardiovascular structures, they can be challenging to surgically resect. Here, we aimed to review three cases of paragangliomas intruding the aortopulmonary (AP) window that required cardiopulmonary bypass (CPB) as an effective surgical approach.
View Article and Find Full Text PDFCureus
October 2024
Cardiothoracic Surgery, Northeast Georgia Medical Center Gainsville, Gainesville, USA.
Mediastinal paragangliomas, though rare, present significant surgical challenges due to their proximity to critical vascular structures within the mediastinum. This case report discusses the management of a patient with an incidentally discovered non-functional mediastinal paraganglioma. The tumor's location necessitated meticulous preoperative planning and intraoperative navigation to prevent vascular injury.
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