新辅助联合术前栓塞治疗与抗利尿激素分泌异常综合征相关的高血管化副神经节瘤

Neoadjuvant Combined Preoperative Embolization of a Highly Vascularized Paraganglioma Associated With SIADH.

作者信息

Gagliardi Maria Felicia, Cantù Edoardo, Tiberti Gianluca, Clerici Alberto, Galanti Andrea, Farina Andrea, Cappello Antonio, Leati Giovanni, Verolino Giuseppe, Triggiani Michele

机构信息

School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.

Department of Cardiac, Thoracic, Vascular Sciences, Alessandro Manzoni Hospital, ASST Lecco, Lecco, Italy; Department of Cardiology, S. Leopoldo Mandic, ASST Lecco, Lecco, Italy.

出版信息

JACC Case Rep. 2025 Feb 19;30(4):102988. doi: 10.1016/j.jaccas.2024.102988.

DOI:10.1016/j.jaccas.2024.102988

PMID:39972712

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11862302/

Abstract

BACKGROUND

Device-based embolization is a well-established medical procedure for treating several pathological conditions, including cerebral and peripheral pseudoaneurysms, congenital defects, and active bleeding. Nonetheless, an intriguing and relatively underexplored application of coils and microparticles involves the preoperative reduction of blood supply to ectopic masses.

CASE SUMMARY

A 58-year-old woman was admitted to our institution with nausea and confusion, with a suspected diagnosis of syndrome of inappropriate antidiuretic hormone secretion. A computed tomography scan revealed a large mediastinal mass receiving blood supply from both the bronchial and coronary arteries. The mass was successfully excised surgically, following the embolization of the major feeding vessels using a combination of coils and microspheres.

DISCUSSION

An uncommon presentation of a paraganglioma characterized by both mass effect and endocrine activity required a "neoadjuvant" treatment to ensure safer surgical management.

TAKE-HOME MESSAGE: The percutaneous reduction of blood supply to tumoral mass could represent an effective strategy to guarantee a radical excision without major complications.

摘要