Department of General Thoracic Surgery, 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, China.
Ningxia Medical University, Yinchuan, China.
Medicine (Baltimore). 2023 Nov 24;102(47):e36327. doi: 10.1097/MD.0000000000036327.
Paragangliomas are rare and can occur in many places throughout the body, but mediastinal paragangliomas are even rarer, accounting for less than 0.3% of mediastinal masses. Extremely susceptible to misdiagnosis and mistreatment, which may lead to the death of the patient.
We report a case of a giant paraganglioma of the middle mediastinum. A 40-year-old woman was admitted to the hospital with a rib fracture and a chest computed tomography suggesting a giant occupying tumor in the middle mediastinum.
Immunohistochemistry revealed positive for S100 fraction and Syn, focally positive for CgA, while negative for CKp and succinate dehydrogenase complex iron sulfur subunit B gene, and Ki67index ≈ 5%. The imaging and immunohistochemical features suggested a final diagnosis of Paragangliomas.
This patient underwent lateral open heart surgery to remove a mediastinal mass.
One month after being discharged, the patient was contacted by phone for a follow-up visit and reported feeling OK. Unfortunately, as of the date of submission, the patient did not come to our hospital for review.
Mediastinal paraganglioma as a rare and potentially malignant tumor susceptible to misdiagnosis and mistreatment. Organ pathology examination is the gold standard for diagnosis, and surgery is an important treatment method. A clear diagnosis and thorough preoperative examination are important guarantees for the success of surgery.
副神经节瘤较为罕见,可发生于全身多个部位,但发生于纵隔的副神经节瘤更为罕见,占纵隔肿瘤的比例不足 0.3%。此类肿瘤极易误诊误治,可导致患者死亡。
我们报告了 1 例纵隔中部巨大副神经节瘤。1 名 40 岁女性因肋骨骨折和胸部 CT 检查提示纵隔中部有巨大占位性肿瘤而入院。
免疫组织化学染色结果显示 S100 亚单位和突触素阳性,嗜铬粒蛋白 A 局灶阳性,细胞角蛋白广谱和琥珀酸脱氢酶复合体铁硫亚基 B 基因阴性,Ki67 指数约为 5%。影像学和免疫组织化学特征提示诊断为副神经节瘤。
患者接受了心脏外侧开胸手术以切除纵隔肿块。
出院后 1 个月,通过电话对患者进行了随访,患者自述恢复良好。不幸的是,截至提交日期,患者尚未来我院复查。
纵隔副神经节瘤是一种罕见的、具有潜在恶性的肿瘤,容易误诊误治。组织病理学检查是诊断的金标准,手术是重要的治疗方法。明确诊断和彻底的术前检查是手术成功的重要保证。