Tuberc Respir Dis.  2011 Feb;70(2):165-169. 10.4046/trd.2011.70.2.165.

A Case of Middle Mediastinal Malignant Paraganglioma

• Park SB
• Park S
• Bang SH
• Kim EK
• Jeon K
• Koh WJ
• Suh GY
• Chung MP
• Kim H
• Kwon OJ
• Go YH
• Um SW

• KMID: 1442868
• DOI: http://doi.org/10.4046/trd.2011.70.2.165

Abstract

Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.

Keyword

Paraganglioma; Mediastinum; Neoplasms

MeSH Terms

Adrenal Medulla
Chromaffin Cells
Headache
Humans
Mediastinoscopy
Mediastinum
Neuroendocrine Tumors
Paraganglioma
Pheochromocytoma
Thorax
Voice

Figure

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  Figure 1 (A) The patient's chest CT scan results. A 34-mm highly enhancing but somewhat heterogeneous soft tissue mass is present in the lower left paratracheal area and in the aorto-pulmonary window of the middle mediastinum on the chest CT scan. (B) The patient's PET/CT scan results. A soft tissue mass with FDG uptake is present in the lower left paratracheal area of the middle mediastinum on the PET/CT scan. (C) The patient's bronchoscopy findings. The mucosa of the carina, left main bronchus, and left side of the lower trachea shows features consistent with hypervascularity on bronchoscopy. CT: computed tomography; PET: positron emission tomography.

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  Figure 2 (A) The result of IHC staining for cytokeratin is negative (×40). (B) The results of IHC staining for synaptophysin (positive) (×200). (C) The results of IHC staining for chromogranin A (positive) (×100). All results are highly suggestive of paraganglioma.

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