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Mediastinal Mass: An Unusual Location for a Paraganglioma
Scott Landreth1, Castigliano Bhamidipati1, Ashok Muralidaran1
1Department of Diagnostic Radiology (S.L., C.F.), Department of Surgery, Division of Cardiothoracic Surgery (C.B., A.M.), and Department of Pathology (D.S.), Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098; and Department of Radiology, University of California, Davis, Sacramento, Calif (B.G.).
Insights
A middle mediastinal mass was incidentally found in an adult during hernia workup. This cardiac neoplasm was diagnosed as a resectable paraganglioma.
Area of Science:
- Cardiovascular Imaging
- Thoracic Oncology
- Diagnostic Radiology
Background:
- Inguinal hernias can occasionally present with incidental findings during diagnostic imaging.
- Mediastinal masses require thorough evaluation due to their proximity to vital structures.
Observation:
- A 50-year-old adult presented for symptomatic inguinal hernia evaluation.
- Contrast-enhanced CT of the chest, abdomen, and pelvis revealed a large, enhancing middle mediastinal mass.
Findings:
- The mass originated from the right ventricular outflow tract.
- Preserved fat planes and coronary arteries indicated resectability.
- Histologic assessment confirmed the diagnosis of mediastinal paraganglioma.
Implications:
- This case highlights the importance of comprehensive CT interpretation, even for unrelated symptoms.
- Mediastinal paragangliomas, though rare, should be considered in the differential diagnosis of middle mediastinal masses.
- Surgical resection is a viable treatment option for resectable mediastinal paragangliomas.
Abstract:
A 50-year-old man presented to the hospital for workup of a symptomatic inguinal hernia. At presurgical workup, findings from a contrast material-enhanced CT of the chest, abdomen, and pelvis revealed a large, well-defined and enhancing middle mediastinal mass arising from the right ventricular outflow tract. The mass was ultimately deemed resectable due to preserved fat planes between the mass and other mediastinal structures and the preservation of the right and left coronary arteries. The tumor was diagnosed as a mediastinal paraganglioma at histologic assessment. Keywords: Adults, Angiography, CT-Angiography, MR-Angiography, Cardiac, Neoplasms-Primary ©RSNA, 2021.
