Innovative approach to a functional mediastinal paraganglioma with anomalous coronary supply: a case report
Open Access
- 1 June 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in European Heart Journal - Case Reports
- Vol. 4 (3), 1-6
- https://doi.org/10.1093/ehjcr/ytaa062
Abstract
Background Mediastinal paragangliomas (PGs) are rare and particularly challenging neuroendocrine tumours. Clinical presentation is heterogeneous and tumour resection can be challenging due to bleeding and the risk of catecholamine surges in functional tumours. Case Summary A 36-year-old man with multiple cardiovascular risk factors was admitted with subacute heart failure. Investigations revealed a large non-metastatic functional mediastinal PG irrigated mainly by a left circumflex coronary anomalous feeder branch. The surgical risk was deemed very high due to patient comorbidities, tumour vascularization, and close relation to major thoracic structures. A multidisciplinary team decided to perform embolization of the anomalous coronary branch followed by peptide-receptor radionuclide therapy with 177-LuDOTATE aiming to decrease tumour size and perioperative risk. Follow-up studies showed a reduction in tumour vascularization, size, and hormonal production. Discussion The innovative strategy of combining embolization of the anomalous feeder branch with radionuclide therapy proved to be a promising approach.This publication has 16 references indexed in Scilit:
- Percutaneous Coronary Intervention for Treatment of Paraganglioma With Coronary VascularizationJACC: Cardiovascular Interventions, 2017
- 68Ga-DOTATATE and 18F-FDG PET/CT in Paraganglioma and Pheochromocytoma: utility, patterns and heterogeneityCancer Imaging, 2016
- Effectiveness and side-effects of peptide receptor radionuclide therapy for neuroendocrine neoplasms in Germany: A multi-institutional registry study with prospective follow-upEuropean Journal of Cancer, 2016
- Arterial embolization with Onyx of head and neck paragangliomasJournal of NeuroInterventional Surgery, 2015
- Laboratory Evaluation of Pheochromocytoma and ParagangliomaClinical Chemistry, 2014
- Increased Mortality in Schizophrenia Due to Cardiovascular Disease – A Non-Systematic Review of Epidemiology, Possible Causes, and InterventionsAmerican Journal of Translational Research, 2014
- Pheochromocytoma and Paraganglioma: An Endocrine Society Clinical Practice GuidelineJournal of Clinical Endocrinology & Metabolism, 2014
- Adrenal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of Oncology, 2012
- Biopsy of pheochromocytomas and paragangliomas: Potential for disasterSurgery, 2009
- Mediastinal Paragangliomas: The Mayo Clinic ExperienceThe Annals of Thoracic Surgery, 2008