Giant non-functional paraganglioma in the posterior mediastinum: A case report

Abstract

We report a 28-year-old man with an initial complaint of back stiffness who was referred to our hospital with an abnormal chest shadow on plain radiography during a medical checkup. A chest computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a hypervascular tumor approximately 10 cm in its longest diameter in the left posterior mediastinum. On positron emission tomography, marked accumulation of fluorodeoxyglucose was observed in the tumor. We suspected paraganglioma, and a serological endocrine examination was performed. The results indicated normal catecholamine levels. I¹²³-metaiodobenzylguanidine (MIBG) scintigraphy showed uptake in the tumor. Histopathological examination of the specimen by CT-guided needle biopsy revealed paraganglioma. The patient underwent resection of the tumor by thoracotomy. Blood transfusion was necessary owing to bleeding from the tumor. The patient was doing well 3 years post-surgery without recurrence. As paragangliomas often have endocrine functions, it is necessary to examine endocrine the function for appropriate perioperative management.