CTICasesEctopic Parathyroid Paraganglioma
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Imaging findings
Breast MRI shows an incidental, highly T2-hyperintense, sausage-shaped solid mass in the superior mediastinum. Contrast-enhanced chest CT confirms a highly vascular, strongly enhancing paratracheal mass located behind the trachea, displacing the esophagus to the left, which remained stable over several years. Histopathologic analysis of the resected mass demonstrates a paraganglioma arising within or immediately adjacent to ectopic parathyroid tissue.
Key takeaways
Mediastinal paragangliomas are rare neuroendocrine tumors that usually arise from sympathetic ganglia or parasympathetic glomus cells near the aorta or pulmonary artery. Extremely rarely, they can develop in association with ectopic parathyroid tissue within the superior mediastinum. On imaging, these lesions typically present as highly vascular, strongly enhancing masses that are hyperintense on T2-weighted MRI. Although they are typically benign and slow-growing, their hypervascularity can make surgical resection challenging.
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