Left ventricular thrombus formation in paraganglioma: a rare but serious complication - a case report

The incidence rate of paraganglioma stands at approximately 1 case per 300 000 person-years. Symptoms resembling anxiety and panic attacks are prevalent within the general populace, rendering the identification of individuals afflicted with pheochromocytoma or paraganglioma a formidable task for healthcare practitioners.

A 43-year-old presented with ischemic signs that turned into necrosis at his left foot due to diffused thrombosis in his main arteries, furthermore Echodiagram indicated the presence of left ventricular thrombosis, through which the diagnosis of paraganglioma was made and confirmed through histological examination.

Paragangliomas are rare tumors originating from extra-adrenal chromaffin cells, typically found in areas such as the carotid body and aortic arch. These tumors can cause cardiovascular issues like hypertension, tachycardia, and thrombus formation. In this case, a paraganglioma was detected below the renal arteries, an uncommon location, with extensive arterial and left ventricular thrombi. Paragangliomas induce a hypercoagulable state due to catecholamine excess, vasospasm, and vascular compression, as seen in this patient, who had thrombi in the lower extremities and aortic artery, increasing embolization risks. Diagnosis involves clinical evaluation, biochemical testing, and imaging studies, with surgical resection as the primary treatment. Preoperative management focuses on controlling blood pressure and glucose, while postoperative care includes anticoagulation therapy. This case highlights the multifaceted vascular complications of paragangliomas, emphasizing the need for a comprehensive diagnostic and treatment approach.

Increasing follow-up sessions with this patient to prevent recurring issues, including the consideration of coronary vascular imaging and administrating anti-coagulant drugs.