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Reminder of important clinical lesson
Mediastinal paraganglioma: time to panic?

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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