Mediastinal Paraganglioma: a Case Report

Abstract

Mediastinal paragangliomas are unusual neoplasms that have been described in the medical literature. The microscopic features of paragangliomas are well established and are essentially similar, regardless of the anatomic site, although some minor differences have been noted according to the location of the tumor. We present a case of nonfunctioning anterior mediastinal paraganglioma in a 33-year-old woman. The mediastinal tumor was accidentally discovered on a thoracic tomographic scan performed for an unrelated minor nasal discomfort. Diagnosis was confirmed by 123I-metaiodobenzylguanidine scintigraphy and mediastinoscopy. Complete resection of the tumor was done through a median sternotomy and the patient received intraoperative radiotherapy.

Posterior mediastinal paragangliomas: A report of three patients with peculiar tumours

“…Mediastinal PG are very uncommon, being most frequently located in the anterior mediastinum and less commonly in the posterior mediastinum 1–3 . Previous reviews of the English language literature have documented fewer than 50 cases of posterior mediastinal PG 1–3 . About 50% of PG of the posterior mediastinum are functional, and about 10% are clinically malignant with metastases 4 .…”

“…Glenner and Grimley have classified the extra‐adrenal paraganglia into four groups based on their anatomic distribution, innervation and microscopic structures. According to this classification mediastinal PG arising from the anterior mediastinum are equivalent to aorticopulmonary PG, and those arising from the posterior mediastinum are equivalent to aorticosympathetic PG 2–4 . Posterior mediastinal PG occur in young adults (average age 29 years) with no gender predilection 2 .…”

“…According to this classification mediastinal PG arising from the anterior mediastinum are equivalent to aorticopulmonary PG, and those arising from the posterior mediastinum are equivalent to aorticosympathetic PG 2–4 . Posterior mediastinal PG occur in young adults (average age 29 years) with no gender predilection 2 . About one half of the patients have symptoms referable to the functional activity of the tumour (palpitation, sweating and hypertension) 3 .…”

“…Surgery alone is the treatment of choice for the well‐circumscribed mediastinal PG 2 . Macroscopically, PG are usually well circumscribed or encapsulated, with grey to tan cut surfaces, which are focally or extensively haemorrhagic.…”

“…Macroscopically, PG are usually well circumscribed or encapsulated, with grey to tan cut surfaces, which are focally or extensively haemorrhagic. Histologically, PG are typically composed of chief cells arranged in nests or cords (zellballen) that are surrounded by an inconspicuous single layer of spindle‐shaped cells called sustentacular cells 1–8 . Gangliocytic PG is an unusual morphologically distinct tumour characterized by a peculiar histological pattern with mixed features of carcinoid tumours, PG and ganglioneuromas 5 .…”