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Case report
Regional metastatic paraganglioma of the bladder: a rare cause of myocardial infarction, reversible cardiomyopathy and an intracardiac thrombus
  1. Vera Kazakova1,
  2. Arun Kadamkulam Syriac2,
  3. Aleksandr Perepletchikov3 and
  4. Ann T Sweeney4
  1. 1Department of Medicine, St Elizabeth's Medical Center, Boston, Massachusetts, USA
  2. 2Hematology/Oncology, Dana Farber Cancer Institute at St Elizabeth's Medical Center, Boston, Massachusetts, USA
  3. 3Pathology, St Elizabeth's Medical Center, Boston, Massachusetts, USA
  4. 4Division of Endocrinology, St Elizabeth's Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Vera Kazakova; vera.kazakova{at}


Sympathetic paragangliomas are rare neuroendocrine tumours that arise from chromaffin cells and secrete catecholamines. On rare occasions, patients with sympathetic paragangliomas can present with symptoms of congestive heart failure. The optimal treatment is surgical to remove all disease and thereby improve survival as well as restore cardiac function. We report a case of a patient with a regional metastatic bladder paraganglioma and a succinate dehydrogenase complex subunit B gene mutation presenting with cardiomyopathy who had significant improvement in his cardiac function with surgical resection despite further progression of metastatic disease. During his 4-year follow-up period, the patient remains free from heart-failure signs and symptoms.

  • heart failure
  • ischaemic heart disease
  • endocrine cancer
  • urological cancer
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  • Contributors VK reviewed the case, drafted the case report and prepared the figures. AP prepared pathology slides and the description of the pathology figure. AKS and ATS have been involved in the long-term management of this patient, participated in writing and editing this case report. All four authors contributed to the editing of the final product.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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