Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2019; 7(12): 1529-1534
Published online Jun 26, 2019. doi: 10.12998/wjcc.v7.i12.1529
Thoracotomy of an asymptomatic, functional, posterior mediastinal paraganglioma: A case report
Yi-Yu Yin, Bin Yang, Yeni Ait Ahmed, Hua Xin
Yi-Yu Yin, Bin Yang, Hua Xin, Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Yeni Ait Ahmed, National Institutes on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, United States
Author contributions: Yin YY contributed to study design and manuscript preparation and revision; Yang B contributed to literature research and clinical studies; Ahmed YA contributed to manuscript editing and language polishing; Xin H contributed to manuscript final version approval.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment
Conflict-of-interest statement: None.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hua Xin, MD, PhD, Chief Doctor, Professor, Chief, Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun 130000, Jinlin Province, China. yinjie17@mails.jlu.edu.cn
Telephone: +86-431-84995999 Fax: +86-431-84995999
Received: January 11, 2019
Peer-review started: January 11, 2019
First decision: March 10, 2019
Revised: March 21, 2019
Accepted: April 18, 2019
Article in press: April 19, 2019
Published online: June 26, 2019
Abstract
BACKGROUND

Paragangliomas in the mediastinum are rare, accounting for only 1%-2% of all paragangliomas and < 0.3% of all mediastinal tumors. Most paragangliomas are nonfunctional, therefore, asymptomatic functional paragangliomas in the left posterior mediastinum are extremely rare. Perioperative management including preoperative preparation, careful intraoperative procedures, and strict postoperative care is important, and one-stage surgical resection should be performed only after appropriate perioperative measures are undertaken. Because those tumors are rare, it is necessary to report known cases to raise awareness regarding them.

CASE SUMMARY

We report the case of a 47-year-old male who was admitted to our hospital with the chief complaints of intermittent tearing pain on the left side of the chest and back for more than 10 mo. A chest contrast-enhanced computed tomography scan revealed a round, solid mass in the left posterior mediastinum, with low-density cystic lesions in the middle, and no enlarged lymph nodes in the hilum or mediastinum (Figure 1). After the diagnosis of paraganglioma, the patient was preoperatively given an oral adrenoceptor blocking drug (phenoxybenzamine), and intravenous fluid resuscitation for two weeks, subsequently the patient underwent a one-stage resection of lesions via left thoracotomy. The patient’s blood pressure increased to 220/120 mmHg when the tumor was touched, which could be relieved by symptomatic treatment such as accelerating liquid transfusion or other intervention to lower blood pressure. The patient recovered uneventfully after surgery, with no abnormal blood pressure or recurrence during one year of follow-up visits.

CONCLUSION

Surgical resection is the preferred treatment for asymptomatic functional paragangliomas.

Keywords: Mediastinal tumor, Paraganglioma, Pheochromocytoma, Hypertension, Case report

Core tip: We present a patient with paraganglioma located in the left posterior mediastinum. After the diagnosis of paraganglioma, the patient was preoperatively given an oral adrenoceptor blocking drug, along with intravenous fluid resuscitation for two weeks, and then underwent one-stage resection of lesions via left thoracotomy. The patient recovered after surgery, with no abnormal blood pressure or recurrence during one year of follow-up visits.