Multimodality Imaging Appearance of Intrapericardial Paragangliomas

Area of Science:

• Cardiovascular Imaging
• Neuroendocrine Tumors
• Pathology

Background:

• Paragangliomas are rare neuroendocrine tumors arising from neural crest cells.
• Intrapericardial paragangliomas, originating from intrinsic cardiac ganglia, constitute less than 1% of all paragangliomas.
• These tumors are typically found in the posterior atria, atrioventricular groove, and near the great vessels.

Purpose of the Study:

• To describe the multimodality imaging characteristics of intrapericardial paragangliomas.
• To review a decade of institutional cases to identify common imaging findings.
• To enhance diagnostic accuracy for these rare cardiac tumors.

Main Methods:

• Retrospective review of a 10-year institutional database.
• Identification of patients with documented intrapericardial paragangliomas.
• Analysis of multimodality imaging features of the identified tumors.

Main Results:

• Nine cases of intrapericardial paragangliomas were identified over 10 years.
• Common imaging findings include tumor embedment and wrapping around great vessels and the atrioventricular groove.
• Tumors demonstrated markedly avid heterogeneous enhancement, engorged neovascularization, and central low attenuation areas in larger lesions.

Conclusions:

• Intrapericardial paragangliomas have distinct imaging features on multimodality scans.
• Characteristic findings include vascular encasement, intense enhancement, and signs of degeneration.
• Recognition of these imaging patterns is crucial for accurate diagnosis and management.