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Reminder of important clinical lesson
Mediastinal paraganglioma: time to panic?
  1. Constantinos A Parisinos1,
  2. Fiona M Carnochan1,
  3. Maria L Gregoriades2,
  4. Hannah Monaghan3,
  5. Dilip Patel2,
  6. William S Walker1
  1. 1Department of Cardiothoracic Surgery, Edinburgh Royal Infirmary, Little France Crescent, Edinburgh, UK
  2. 2Department of Radiology, Edinburgh Royal Infirmary, Little France Crescent, Edinburgh, UK
  3. 3Department of Laboratory Medicine (Pathology), Edinburgh Royal Infirmary, Little France Crescent, Edinburgh, UK
  1. Correspondence to Dr Constantinos A Parisinos, c.a.parisinos{at}gmail.com

Summary

Paragangliomas (extra-adrenal phaeochromocytomas) are tumours arising from extra-adrenal chromaffin tissue. The authors describe a case of a 54-year-old woman presenting with shortness of breath and chest pain. CT pulmonary angiogram demonstrated a mediastinal mass. Further history taking revealed spontaneous attacks of headaches and palpitations. Subsequent imaging and biochemical testing confirmed the presence of a rare posterior mediastinal paraganglioma.

The patient was prepared for surgery. A left thoracolaparotomy was performed and the mass was excised in its entirety. Postoperatively, 24-h urine collections showed normal normetanephrine and metanephrine levels. Since then, yearly catecholamine levels remain within the normal range.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.