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(Circulation. 2008;118:574-575.)
© 2008 American Heart Association, Inc.

Images in Cardiovascular Medicine

Paracardiac Nonfunctioning Paraganglioma in a Young Woman

Cecilia Corros Vicente, MD; Enrique Rodriguez, MD; Paloma Aragoncillo, PhD; Joaquin Ferreiros, MD; Manuel Carnero, MD; Leopoldo Pérez-Isla, MD; Rosana Hernandez-Antolín, PhD; Carlos Macaya, PhD; Isidre Vilacosta, PhD

From Departments of Cardiology (C.C.V., L.P.-I., R.H.-A., C.M., I.V.), Cardiac Surgery (E.R., M.C.), Pathology (P.A.), and Radiology (J.F.) of the Hospital Clinico San Carlos, Madrid, Spain.

Correspondence to C. Corros Vicente, MD, Unidad de Cardiología, Hospital Clínico San Carlos, Calle Martin Lagos, Madrid, 28040 Spain. E-mail ceciliacorros@yahoo.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Paraganglioma, also referred to as pheochromocytoma when functionally active, is a rare tumor thought to arise from the neuroectodermally derived paraganglionic cells that are dispersed widely along the autonomic ganglia. Mediastinal localization is very rare and the clinical presentation is variable. In most cases, hypertension due to catecholamine excess is the main clinical manifestation; however, the majority of these tumors are asymptomatic.

A 36-year-old woman presented to her general practitioner with wheezing and dyspnea on exercise. Asthma was diagnosed, and she was treated with inhaled administration of a corticosteroid and a β₂-agonist. Chest x-ray revealed a well-circumscribed, rounded mass at the level of the pulmonary artery (Figure 1), and the patient was referred to our institution for further evaluation. Her physical examination was unremarkable, and laboratory test results were essentially normal without elevation of serum tumor markers. Determinations of norepinephrine and normetanephrine levels were normal. Magnetic resonance imaging showed a hypervascularized mass in the middle mediastinum that extended from the anterior wall of the left atrium to the aortopulmonary window (Figure 2). Positron emission tomography revealed a focal increase in [¹⁸F]fluorodeoxyglucose uptake in the mediastinum. Because of the close proximity of this mass to the heart, a coronary angiography was performed (Figure 3), which revealed a highly vascularized mass receiving branches from the proximal left anterior descending and circumflex arteries. In the differential diagnosis of the mass, we considered teratoma (on the basis of the mass location and the patient’s clinical profile), . . . [Full Text of this Article]