Surgical resection of a posterior mediastinal paraganglioma with intraoperative hypertension: A case report

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  • 術中異常高血圧を呈した後縦隔傍神経節腫の1切除例

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Abstract

Paragangliomas (PG) of the post-mediastinum are rare neoplasms. Herein, we report a case of post-mediastinal PG with abnormal blood pressure and unexpected massive bleeding during surgery. The patient was a 60-year-old man with an abnormal shadow observed on chest radiography during a routine medical check-up. Computed tomography and magnetic resonance imaging showed the presence of a right posterior mediastinal tumor. With the diagnosis of a posterior mediastinal neurogenic tumor, video-assisted thoracic surgery (VATS) was performed. During the surgery, his systolic blood pressure increased to over 220 mmHg and he bled easily. We had convert to a standard thoracotomy due to the poor control of massive bleeding (over 200 ml). After tumor resection, his blood pressure stabilized. The tumor was pathologically diagnosed as a PG. Post-mediastinal PG has been reported in only 28 cases in Japan. It is difficult to preoperatively diagnose. If PG is diagnosed during surgery, this case suggests the importance of prompt consultation with an anesthesiologist and immediate resection.

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