tailieunhanh - Báo cáo y học: "Paraganglioma of the mediastinum: challenges in diagnosis and surgical management."

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Paraganglioma of the mediastinum: challenges in diagnosis and surgical management. | Wald et al. Journal of Cardiothoracic Surgery 2010 5 19 http content 5 1 19 JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Paraganglioma of the mediastinum challenges in diagnosis and surgical management Ori Wald Oz M Shapira Aiman Murar and Uzi Izhar Abstract Mediastinal paraganglioms are rare highly vascularized tumors arising from chromaffin tissue located in the para-aortic ganglia. Tumors tend to invade bordering structures and may also form metastasis. Up to 50 of patients are asymptomatic and diagnosis is incidental. Presenting symptoms are related to catecholamine hypersecretion or to a mass effect. Complete surgical resection remains the standard of care due to malignant potential of the tumor and poor response to chemotherapy or radiation. Strategic location of the tumor in proximity to great vessels trachea and recurrent laryngeal nerve poses challenge for the surgeon. We report a case of a 59-year old asymptomatic female who was incidentally diagnosed with a middle mediastinal mass on a positron-emission tomography PET-CT scan performed as part of breast cancer surveillance. Complete resection of the tumor was achieved using cardiopulmonary bypass. The patient recovered uneventfully and in a ten-month follow up there is no evidence of recurrence. Introduction Ninety percent of chromaffin-cell-originating tumors are located in the adrenal gland and termed pheochromocytomas. The remaining ten percent are extra adrenal and are termed paragangliomas. Paragangliomas appear in the abdomen pelvis neck and mediastimun. Mediastinal paraganglioma originate from para-aortic middle medi-atsinum and para-vertebral posterior mediatsinum sympathetic chain ganglia 1 2 . Similar to pheochromocytoma paraganglioma tumors may secrete catecholamines however in majority of cases they are nonfunctional. Up to 50 of patients are asymptomatic and the diagnosis is incidental 1 . Clinical symptoms may be related to catecholamine .