CTICasesMediastinal Paraganglioma
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Imaging findings
CT of the chest demonstrates a large, hypervascular, well-encapsulated, precarinal mediastinal mass that causes posterior displacement of the trachea and carina and exerts mild mass effect on the pulmonary arteries. Octreotide scintigraphy reveals intense radiotracer avidity within the mass.
Key takeaways
Mediastinal paraganglioma is a highly vascular neuroendocrine tumor arising from extra-adrenal chromaffin cells. Biopsy can be non-diagnostic due to extensive fibrovascular tissue, and resection is the definitive management. Patients with one paraganglioma are at risk for multicentric disease (e.g., prior carotid body tumors) and should be evaluated for genetic syndromes such as succinate dehydrogenase (SDH) mutations.
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