Surgical resection of a middle mediastinal paraganglioma that caused diabetes

Abstract Background Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Med...

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Main Authors: Kentaro Miura, Nobutaka Kobayashi, Hidetoshi Satomi
Format: Article
Language:English
Published: Japan Surgical Society 2020-09-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-00983-x
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author Kentaro Miura
Nobutaka Kobayashi
Hidetoshi Satomi
author_facet Kentaro Miura
Nobutaka Kobayashi
Hidetoshi Satomi
author_sort Kentaro Miura
collection DOAJ
description Abstract Background Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Mediastinum paragangliomas is rare and commonly originate from the posterior mediastinum, while those originating from the middle posterior are quite rare. Some paragangliomas secrete catecholamines, leading to symptoms such as hypertension, tachycardia, and diabetes. Case presentation A 76-year-old woman visited our hospital for the treatment and further evaluation of diabetes. Her hemoglobin A1c levels had risen to 11.0%. To investigate the cause of her diabetes, a contrast-enhanced chest computed tomography scan was performed, revealing a ring-enhancing tumor (30 × 30 mm) in the middle mediastinum. The surgical resection was performed via video-assisted thoracic surgery. Surgery was performed using a vessel-sealing device; however, bleeding was persistent from the surrounding tissue. Total bleeding was 400 g. Blood pressure fluctuations and arrhythmia did not occur during the operation. The patient’s uncontrolled diabetes was cured after the surgery, and the tumor was diagnosed as a functional paraganglioma. Conclusions We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.
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spelling doaj-art-3a3c7628f7854c679292e330495ea4532025-08-20T03:56:13ZengJapan Surgical SocietySurgical Case Reports2198-77932020-09-01611410.1186/s40792-020-00983-xSurgical resection of a middle mediastinal paraganglioma that caused diabetesKentaro Miura0Nobutaka Kobayashi1Hidetoshi Satomi2Department of Thoracic Surgery, Japanese Red Cross Society Nagano HospitalDepartment of Thoracic Surgery, Japanese Red Cross Society Nagano HospitalDepartment of Pathology, Japanese Red Cross Society Nagano HospitalAbstract Background Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Mediastinum paragangliomas is rare and commonly originate from the posterior mediastinum, while those originating from the middle posterior are quite rare. Some paragangliomas secrete catecholamines, leading to symptoms such as hypertension, tachycardia, and diabetes. Case presentation A 76-year-old woman visited our hospital for the treatment and further evaluation of diabetes. Her hemoglobin A1c levels had risen to 11.0%. To investigate the cause of her diabetes, a contrast-enhanced chest computed tomography scan was performed, revealing a ring-enhancing tumor (30 × 30 mm) in the middle mediastinum. The surgical resection was performed via video-assisted thoracic surgery. Surgery was performed using a vessel-sealing device; however, bleeding was persistent from the surrounding tissue. Total bleeding was 400 g. Blood pressure fluctuations and arrhythmia did not occur during the operation. The patient’s uncontrolled diabetes was cured after the surgery, and the tumor was diagnosed as a functional paraganglioma. Conclusions We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.http://link.springer.com/article/10.1186/s40792-020-00983-xParagangliomaMiddle mediastinumFunctionalSurgical resectionDiabetes
spellingShingle Kentaro Miura
Nobutaka Kobayashi
Hidetoshi Satomi
Surgical resection of a middle mediastinal paraganglioma that caused diabetes
Surgical Case Reports
Paraganglioma
Middle mediastinum
Functional
Surgical resection
Diabetes
title Surgical resection of a middle mediastinal paraganglioma that caused diabetes
title_full Surgical resection of a middle mediastinal paraganglioma that caused diabetes
title_fullStr Surgical resection of a middle mediastinal paraganglioma that caused diabetes
title_full_unstemmed Surgical resection of a middle mediastinal paraganglioma that caused diabetes
title_short Surgical resection of a middle mediastinal paraganglioma that caused diabetes
title_sort surgical resection of a middle mediastinal paraganglioma that caused diabetes
topic Paraganglioma
Middle mediastinum
Functional
Surgical resection
Diabetes
url http://link.springer.com/article/10.1186/s40792-020-00983-x
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AT hidetoshisatomi surgicalresectionofamiddlemediastinalparagangliomathatcauseddiabetes