Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report
Abstract Background Paragangliomas are rare neuroendocrine tumors predominantly located within the adrenal gland. Extra-adrenal paragangliomas, particularly those in the anterosuperior mediastinum, are exceedingly rare and pose significant diagnostic and therapeutic challenges due to their complex a...
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BMC
2025-04-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03283-9 |
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| author | Zheng Wang Wenkang Zong Shuo Liang Fang Zhou Xike Lu Daqiang Sun |
| author_facet | Zheng Wang Wenkang Zong Shuo Liang Fang Zhou Xike Lu Daqiang Sun |
| author_sort | Zheng Wang |
| collection | DOAJ |
| description | Abstract Background Paragangliomas are rare neuroendocrine tumors predominantly located within the adrenal gland. Extra-adrenal paragangliomas, particularly those in the anterosuperior mediastinum, are exceedingly rare and pose significant diagnostic and therapeutic challenges due to their complex anatomical location. Case description A 42-year-old woman was found to have an anterosuperior mediastinal mass during a routine health screening. Enhanced chest computed tomography (CT) revealed an ovoid, low-density mass intricately associated with major vascular structures including the superior vena cava, brachiocephalic trunk, left common carotid artery, aortic arch, right anonymous vein, and right subclavian artery. Despite significant intraoperative blood loss of 2000 ml, the mass was successfully excised with meticulous surgical technique and effective hemostasis. Histopathological examination showed a classic Zellballen pattern with chief cells and sustentacular cells embedded in a vascular-rich stroma. Immunohistochemistry confirmed the tumor’s chromaffin nature, with chief cells testing positive for CD56, Synaptophysin, and Chromogranin A, and sustentacular cells positive for S100 protein, consistent with a diagnosis of paraganglioma. The patient’s postoperative recovery was uneventful, and she was discharged one week after surgery. Conclusions This case highlights the essential role of comprehensive preoperative imaging and the necessity for interdisciplinary surgical expertise in managing complex mediastinal paragangliomas. Advanced surgical techniques and careful intraoperative management are paramount to achieving successful outcomes. Appropriate imaging modalities and auxiliary laboratory tests are crucial for early detection of recurrences in these rare tumors. |
| format | Article |
| id | doaj-art-4cc9a9bf5ee5496d93d4770cd8e4e217 |
| institution | OA Journals |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
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| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-4cc9a9bf5ee5496d93d4770cd8e4e2172025-08-20T02:12:02ZengBMCJournal of Cardiothoracic Surgery1749-80902025-04-012011610.1186/s13019-024-03283-9Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case reportZheng Wang0Wenkang Zong1Shuo Liang2Fang Zhou3Xike Lu4Daqiang Sun5Department of Thoracic Surgery, Tianjin Chest Hospital Affiliated to Tianjin UniversityDepartment of Pathology, TTianjin Chest Hospital Affiliated to Tianjin UniversityDepartment of Radiology, Tianjin Chest Hospital Affiliated to Tianjin UniversityDepartment of Thoracic Surgery, Tianjin Chest Hospital Affiliated to Tianjin UniversityDepartment of Thoracic Surgery, Tianjin Chest Hospital Affiliated to Tianjin UniversityDepartment of Thoracic Surgery, Tianjin Chest Hospital Affiliated to Tianjin UniversityAbstract Background Paragangliomas are rare neuroendocrine tumors predominantly located within the adrenal gland. Extra-adrenal paragangliomas, particularly those in the anterosuperior mediastinum, are exceedingly rare and pose significant diagnostic and therapeutic challenges due to their complex anatomical location. Case description A 42-year-old woman was found to have an anterosuperior mediastinal mass during a routine health screening. Enhanced chest computed tomography (CT) revealed an ovoid, low-density mass intricately associated with major vascular structures including the superior vena cava, brachiocephalic trunk, left common carotid artery, aortic arch, right anonymous vein, and right subclavian artery. Despite significant intraoperative blood loss of 2000 ml, the mass was successfully excised with meticulous surgical technique and effective hemostasis. Histopathological examination showed a classic Zellballen pattern with chief cells and sustentacular cells embedded in a vascular-rich stroma. Immunohistochemistry confirmed the tumor’s chromaffin nature, with chief cells testing positive for CD56, Synaptophysin, and Chromogranin A, and sustentacular cells positive for S100 protein, consistent with a diagnosis of paraganglioma. The patient’s postoperative recovery was uneventful, and she was discharged one week after surgery. Conclusions This case highlights the essential role of comprehensive preoperative imaging and the necessity for interdisciplinary surgical expertise in managing complex mediastinal paragangliomas. Advanced surgical techniques and careful intraoperative management are paramount to achieving successful outcomes. Appropriate imaging modalities and auxiliary laboratory tests are crucial for early detection of recurrences in these rare tumors.https://doi.org/10.1186/s13019-024-03283-9Anterosuperior mediastinal paragangliomaSurgical managementDiagnostic imagingMultidisciplinary approachCase report |
| spellingShingle | Zheng Wang Wenkang Zong Shuo Liang Fang Zhou Xike Lu Daqiang Sun Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report Journal of Cardiothoracic Surgery Anterosuperior mediastinal paraganglioma Surgical management Diagnostic imaging Multidisciplinary approach Case report |
| title | Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report |
| title_full | Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report |
| title_fullStr | Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report |
| title_full_unstemmed | Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report |
| title_short | Anterosuperior mediastinal paraganglioma in a 42-Year-old woman: a diagnostic and therapeutic challenge—a case report |
| title_sort | anterosuperior mediastinal paraganglioma in a 42 year old woman a diagnostic and therapeutic challenge a case report |
| topic | Anterosuperior mediastinal paraganglioma Surgical management Diagnostic imaging Multidisciplinary approach Case report |
| url | https://doi.org/10.1186/s13019-024-03283-9 |
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