Management dilemma in case of a posterior mediastinal paraganglioma

Abstract

We report a case of functional mediastinal paraganglioma supplied by the left circumflex artery, associated with bilateral carotid body tumors. The surgical approach for a tumor in the posterior mediastinum behind the left atrium was a dilemma because the majority of the tumor was in the right hemithorax but its major blood supply was from the left circumflex artery in the left hemithorax. Management involved preoperative coil embolization of the feeding vessel followed by complete excision of the tumor through a right thoracotomy, without employing cardiopulmonary bypass, and excision of the carotid body tumors in a staged manner.