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Published on: September 15, 2017
Cardiac Paraganglioma
1Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St Luke's Medical Centers, Milwaukee, Wisconsin, USA.
Background:
Cardiac paragangliomas are rare neuroendocrine tumors that can present with catecholaminergic symptoms or be discovered incidentally. Multimodality imaging and genetic testing are central to diagnosis and management.
Case Summary:
A 76-year-old woman with paroxysmal atrial fibrillation and recurrent gastrointestinal bleeding underwent preprocedural imaging with cardiac computed tomography angiography for left atrial appendage occlusion, which revealed a large mass near the ascending aorta encasing the proximal right coronary artery. Surgical resection of the mass was performed. Histopathology confirmed the presence of paraganglioma. Genetic analysis identified a hereditary gene mutation.
Discussion:
Cardiac paragangliomas are rare tumors that require a high index of suspicion. This case demonstrates the diagnostic value of advanced imaging in cardiac tumors and illustrates the role of genetic testing in identifying heritable paraganglioma syndromes.
Take-Home Messages:
Multimodality imaging is important in the diagnosis of cardiac masses. Surgical resection is the primary treatment for cardiac paragangliomas.
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