Robotic approach to a subcarinal functional paraganglioma

Respiratory Medicine Case Reports
Andrew G MarthyWalter Scott

Abstract

Functional mediastinal paragangliomas arise from extra-adrenal tissues and are rare. These cases create challenges related to diagnosis, peri-operative management, and surgical management. We present a case that demonstrates a planned robot-assisted thoracoscopic resection of a mediastinal paraganglioma that ultimately required a trans-sternal resection of the tumor off the left atrium. Our patient is a 42-year-old male with a prolonged history of refractory hypertension, palpitations, headaches, and diaphoresis, which led to the discovery of a subcarinal functional mediastinal paraganglioma. The patient was brought to the operating room for a right robotic-assisted thoracoscopic subcarinal dissection with attempted resection of the mass. Subsequently, the patient's paraganglioma was successfully resected off the left atrium using a trans-sternal approach, cardiopulmonary bypass, and cardioplegic arrest. He was successfully transitioned to minimal anti-hypertensive medication post-operatively. Pheochromocytomas are neural-crest derived tumors that typically arise from the adrenal medulla. Rarely, paragangliomas arise in the thoracic cavity, at an approximate incidence of 2%. Our sequential approach offered the potential for a m...Continue Reading

References

Mar 27, 2003·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·E Edström ElderB Hamberger
Aug 23, 2005·Lancet·Jacques W M LendersKarel Pacak
Nov 29, 2007·Endocrine·Wen-Qi YuanGuang Ning
Aug 30, 2008·The Annals of Thoracic Surgery·Morgan L BrownHartzell V Schaff
Apr 30, 2017·Journal of Thoracic Disease·Mingzhi SongQingwei Tan

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