CTICasesRecurrent Mediastinal Paraganglioma
Imaging findings
Initial chest CT shows a massive, highly vascular prevascular mediastinal mass with extensive central necrosis and prominent feeding vessels, which required complex surgical resection. Follow-up CT scan obtained three years post-resection reveals a new, small, strongly enhancing soft-tissue nodule located superiorly in the left mediastinum between the left subclavian and left common carotid arteries.
Key takeaways
Paragangliomas of the mediastinum are highly vascular neuroendocrine tumors that can reach a very large size and present as necrotic mediastinal masses. Due to their infiltrative nature and relationship with major cardiothoracic structures, complete surgical resection is challenging, and patients require long-term surveillance as these tumors can recur locally several years after initial treatment.
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