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A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter
INTRODUCTION AND IMPORTANCE: Mediastinal paragangliomas are rare neuroendocrine tumors that originate from extra-adrenal paraganglia, occasionally secreting catecholamines. Nonfunctional mediastinal paragangliomas present nonspecific clinical and radiological features and represent a diagnostic chal...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408516/ https://www.ncbi.nlm.nih.gov/pubmed/34464842 http://dx.doi.org/10.1016/j.ijscr.2021.106357 |
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author | Bianchi, Daniel Scamporlino, Adriana Costantini, Matteo Cavallesco, Giorgio Morandi, Uliano Stefani, Alessandro |
author_facet | Bianchi, Daniel Scamporlino, Adriana Costantini, Matteo Cavallesco, Giorgio Morandi, Uliano Stefani, Alessandro |
author_sort | Bianchi, Daniel |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Mediastinal paragangliomas are rare neuroendocrine tumors that originate from extra-adrenal paraganglia, occasionally secreting catecholamines. Nonfunctional mediastinal paragangliomas present nonspecific clinical and radiological features and represent a diagnostic challenge. CASE PRESENTATION: A 53-year old woman presented with cough and dyspnea increasing over time. CT-scan and ultrasonography showed a large vascularized cervico-mediastinal mass, consistent with an intrathoracic ectopic goiter. Preoperative angiography showed a blood supply from neck vessels. The lesion was completely removed through a cervical approach. The diagnosis of paraganglioma was a histological surprise. The patient is alive without recurrence 30 months after surgery. CLINICAL DISCUSSION: When preoperatively diagnosed, the treatment of choice of a mediastinal paraganglioma is surgical excision. However, a preoperative diagnosis of mediastinal paraganglioma is difficult to obtain, especially in cases of nonfunctional lesions. Distinction between an intrathoracic goiter and a nonfunctional paraganglioma can be extremely difficult and, given the rarity of the latter, an ectopic goiter is suspected in first instance. CT-scan and ultrasonography are of little use in the differential diagnosis. However, scintigraphy with (123)I-metaiodobenzylguanidine can be an useful diagnostic tool when a paraganglioma is suspected. In case of vascularized cervico-mediastinal mass, such as paragangliomas or intrathoracic goiter, preoperative angiography should be performed to study the blood supply and orient the surgical approach. CONCLUSION: Although uncommon, paragangliomas should be considered in the differential diagnosis of mediastinal masses, especially when an ectopic goiter is suspected. |
format | Online Article Text |
id | pubmed-8408516 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-84085162021-09-03 A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter Bianchi, Daniel Scamporlino, Adriana Costantini, Matteo Cavallesco, Giorgio Morandi, Uliano Stefani, Alessandro Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Mediastinal paragangliomas are rare neuroendocrine tumors that originate from extra-adrenal paraganglia, occasionally secreting catecholamines. Nonfunctional mediastinal paragangliomas present nonspecific clinical and radiological features and represent a diagnostic challenge. CASE PRESENTATION: A 53-year old woman presented with cough and dyspnea increasing over time. CT-scan and ultrasonography showed a large vascularized cervico-mediastinal mass, consistent with an intrathoracic ectopic goiter. Preoperative angiography showed a blood supply from neck vessels. The lesion was completely removed through a cervical approach. The diagnosis of paraganglioma was a histological surprise. The patient is alive without recurrence 30 months after surgery. CLINICAL DISCUSSION: When preoperatively diagnosed, the treatment of choice of a mediastinal paraganglioma is surgical excision. However, a preoperative diagnosis of mediastinal paraganglioma is difficult to obtain, especially in cases of nonfunctional lesions. Distinction between an intrathoracic goiter and a nonfunctional paraganglioma can be extremely difficult and, given the rarity of the latter, an ectopic goiter is suspected in first instance. CT-scan and ultrasonography are of little use in the differential diagnosis. However, scintigraphy with (123)I-metaiodobenzylguanidine can be an useful diagnostic tool when a paraganglioma is suspected. In case of vascularized cervico-mediastinal mass, such as paragangliomas or intrathoracic goiter, preoperative angiography should be performed to study the blood supply and orient the surgical approach. CONCLUSION: Although uncommon, paragangliomas should be considered in the differential diagnosis of mediastinal masses, especially when an ectopic goiter is suspected. Elsevier 2021-08-27 /pmc/articles/PMC8408516/ /pubmed/34464842 http://dx.doi.org/10.1016/j.ijscr.2021.106357 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Bianchi, Daniel Scamporlino, Adriana Costantini, Matteo Cavallesco, Giorgio Morandi, Uliano Stefani, Alessandro A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title | A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title_full | A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title_fullStr | A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title_full_unstemmed | A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title_short | A case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
title_sort | case of cervico-mediastinal paraganglioma mimicking an ectopic goiter |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408516/ https://www.ncbi.nlm.nih.gov/pubmed/34464842 http://dx.doi.org/10.1016/j.ijscr.2021.106357 |
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