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纵隔副神经节瘤:病例报告及文献复习。

Middle mediastinal paraganglioma: A case report and review of the literature.

机构信息

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.

出版信息

Medicine (Baltimore). 2023 Nov 24;102(47):e36327. doi: 10.1097/MD.0000000000036327.

Abstract

RATIONAL

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.

PATIENT CONCERNS

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.

DIAGNOSIS

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.

INTERVENTIONS

This patient underwent lateral open heart surgery to remove a mediastinal mass.

OUTCOMES

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.

LESSONS

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.

摘要

背景

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。

病例介绍

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。

诊断

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。

治疗

患者接受了心脏外侧开胸手术以切除纵隔肿块。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b63d/10681380/469fdf34c517/medi-102-e36327-g001.jpg

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