Primary unresectable locally invasive biatrial paraganglioma presenting with chest pain (original) (raw)

2018, Human Pathology: Case Reports

AI-generated Abstract

Primary cardiac paragangliomas are rare tumors that can present with ischemic symptoms. A case of a 43-year-old female with an unresectable paraganglioma located above the right atrium is reported, demonstrating intense peripheral enhancement on imaging. Histopathology confirmed the diagnosis with a characteristic 'Zellballen' pattern, while immunohistochemical studies indicated an SDHB gene mutation. The absence of adrenergic symptoms complicated the diagnosis, underscoring the importance of considering paragangliomas in the differential diagnosis of cardiac neoplasms.

Cardiac Paraganglioma—A Rare Subset of a Rare Tumor

World Journal of Cardiovascular Diseases, 2017

Background: Cardiac paraganglioma is a rare entity of an uncommon neuroendocrine tumor. Clinically, non-secreting tumors are often diagnosed because of their growth effects, secreting tumors present symptoms related to catecholamine. Correct diagnosis of a paraganglioma can be reached by biochemical investigations and imaging. Surgical resection is the treatment of choice and has to be planned carefully and interdisciplinarily. Aim: On the basis of a patient with a vague clinical presentation and an unclear situation after primary investigations, we highlight the diagnostic challenge of this rare subset of paragangliomas. Case presentation: We present the case of a 42year-old woman whose unspecific symptoms and further investigations revealed a paracardiac mass with unknown local behavior and dignity. Surgical resection and histopathological examination led to the diagnosis of a cardiac paraganglioma. Conclusion: Cardiac paragangliomas are extremely rare, but may be treated curatively by resection after careful preoperative investigation and interdisciplinary planning.

A Series of Two Patients With Cardiac Paragangliomas

AACE Clinical Case Reports, 2020

Objective: The objective of this report is to present 2 cases of cardiac paragangliomas (PGLs), and to outline the presentation, management, and associated genetic mutations. Methods: Case 1, a 38-year-old female, presented with a 12-month history of paroxysmal palpitations, headaches, and weight loss. Her investigations included plasma free metanephrines and urinary metanephrines, 68-gallium DOTATATE positron emission tomography/computed tomography, and cardiac imaging. Case 2, a 28-year-old male, presented with a hypertensive crisis and abdominal pain on a background of hypertension. Given his abdominal pain, he was investigated with an abdominal computed tomography (CT) scan, followed by plasma free metanephrines and urinary metanephrines, echocardiogram, and 123-iodine meta-iodobenzylguanidine single-photon emission CT. Results: Case 1 had an elevated plasma normetadrenaline of 6,750 pmol/L (reference range is <900 pmol/L) and 3-methoxytyramine of 1,845 pmol/L (reference range is <110 pmol/L). 68-gallium DOTATATE positron emission tomography/computed tomography showed an avid Abbreviations: CT = computed tomography; MRI = magnetic resonance imaging; PGL = paraganglioma; SDH = succinate dehydrogenase Plasma free metanephrines Reference range

Diagnostic Imaging and Treatment of a Left Atrial Paraganglioma

Texas Heart Institute Journal

Diagnostic Imaging and Treatment of a Left Atrial Paraganglioma A 24-year-old woman presented for evaluation of episodic hypertension (blood pressure up to 190/122 mmHg) associated with palpitations. She used no illicit drugs. Holter monitoring revealed no arrhythmia. A 24-hour urine test revealed extremely high levels of catecholamine metabolites (vanillylmandelic acid, metanephrine, and normetanephrine). An echocardiogram showed a left atrial (LA) mass (Fig. 1). An iodine (I-123) metaiodobenzylguanidine (MIBG) single-photon-emission computed tomogram showed intense tracer uptake only in the subcarinal area (Fig. 2). A T1-weighted echo inversion-recovery cardiac magnetic resonance sequence revealed a nonmobile, well-circumscribed 2.4 × 3.2 × 2.7-cm mass in the posterior LA wall (Fig. 3). The mass had a high signal intensity on T1-and T2-weighted images, with substantial contrast enhancement. To prevent a hypertensive crisis during surgery, we treated the patient with phenoxybenzamine for several days. The mass was in the LA roof, between the right and left pulmonary veins (Fig. 4). We resected the tumor with a margin of normal atrial tissue (Fig. 5) and closed the incision by using autologous pericardium. Histologic findings

A rare case of cardiac paraganglioma presenting as anginal pain: a case report

Cases Journal, 2009

Introduction: Primary cardiac paraganglioma is a very rare tumor with less than sixty reported cases in the literature. The clinical presentation is variable, but is most commonly manifested by hypertension and symptoms related to the catecholamine excess. Case Report: We report a case of a 35 year old man who presented with anginal pain and hypertension. He was found to have a cardiac mass on the computed tomographic scan and echocardiogram. He underwent surgical exploration of the mass which on biopsy was found to be a 'Cardiac Paraganglioma'. Surgical resection of the tumor was successfully done and the patient is doing well five years after the surgery without any evidence of recurrence. His blood pressure, however, failed to normalize and needed single agent antihypertensive therapy. Conclusion: Cardiac paragangliomas have a relatively favorable outcome if diagnosed and resected in time. We briefly review the literature regarding the diagnosis, treatment and prognosis of this rare tumor.

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.