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Paraganglioma arising from the liver and abutting the heart
  1. Hussein Kharroubi1,
  2. Tedy Sawma1,
  3. Pierre Sfeir2 and
  4. Mohammad Khalife2
  1. 1Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  2. 2Surgery, American University of Beirut Medical Center, Beirut, Lebanon
  1. Correspondence to Dr Mohammad Khalife; mk12{at}


A paraganglioma is a rare extra-adrenal neuroendocrine tumour with a variable clinical presentation. A paraganglioma can arise anywhere along the sympathetic and parasympathetic chains, but it can occasionally emerge from unusual locations such as the liver and the thoracic cavity. We report a rare case of a woman in her 30s who presented to our emergency department with symptoms of chest discomfort, episodic hypertension, tachycardia and diaphoresis. A diagnostic approach including a chest X-ray, an MRI and a positron emission tomography–CT scan showed a large exophytic liver mass protruding into the thoracic cavity. For further characterisation of the mass, a biopsy of the lesion was performed, demonstrating that the tumour is of neuroendocrine origin. This was supported by a urine metanephrine test showing high levels of catecholamine breakdown products. Treatment consisted of a unique multidisciplinary approach involving hepatobiliary and cardiothoracic surgery allowing a safe and complete extermination of the hepatic tumour and its cardiac extension.

  • Surgery
  • Cancer intervention
  • Liver disease
  • Hepatic cancer
  • Endocrine cancer

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  • Contributors MK and PS performed the surgery and edited the manuscript. HK and TS collected the data, reviewed the literature and wrote the manuscript.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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