Division of Cardiology, Department of Internal Medicine, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, 42415, Republic of Korea.
Department of Pathology, Yeungnam University College of Medicine, Daegu, Republic of Korea.
BMC Cardiovasc Disord. 2020 Nov 23;20(1):492. doi: 10.1186/s12872-020-01752-2.
Paragangliomas are tumors that arise from extra-adrenal chromaffin cells. Herein, we present a rare case of a functional paraganglioma in the posterior mediastinum.
A 36-year-old man presented with paroxysms of chest pain and headache. At presentation, the patient's blood pressure was 190/120 mmHg. Chest computed tomography and magnetic resonance imaging revealed a left paravertebral mass in the posterior mediastinum. I-metaiodobenzylguanidine scanning revealed focally high tracer uptake in the left paravertebral area. The metanephrine level in the urine was elevated, confirming a rare, catecholamine-producing, functional paraganglioma in the posterior mediastinum. Before surgery, the patient was prepared by orally administering α- and β-adrenergic blockers. The mass was then resected via a lateral thoracotomy. The metanephrine level in urine was normal 24 h after surgery.
Paragangliomas in the posterior mediastinum are very rare, but more than half of all cases are functional. The associated symptoms are curable with complete resection, and long-term follow-up for recurrence is important.
副神经节瘤起源于肾上腺外的嗜铬细胞。本文报告了一例罕见的后纵隔功能性副神经节瘤病例。
一名 36 岁男性因胸痛和头痛发作就诊。就诊时,患者的血压为 190/120mmHg。胸部计算机断层扫描和磁共振成像显示后纵隔左侧椎旁肿块。I-间碘苄胍扫描显示左椎旁区域有局灶性高示踪剂摄取。尿中甲氧基肾上腺素水平升高,证实了罕见的、产生儿茶酚胺的、位于后纵隔的功能性副神经节瘤。手术前,患者通过口服α和β肾上腺素能阻滞剂进行准备。然后通过侧开胸术切除肿块。术后 24 小时,尿液中甲氧基肾上腺素水平正常。
后纵隔副神经节瘤非常罕见,但超过一半的病例为功能性。相关症状可通过完全切除治愈,长期随访复发情况很重要。