Extraadrenal Biatrial Cardiac Paraganglioma: Diagnosis, Histological Criteria and Surgical Management

Fig 2. Pthat originate from the neural crest. We report a case of successful surgical treatment of a noncatecholamineproducing cardiac paraganglioma in a 25-year-old white male patient with dyspnea on exertion and intermittent palpitations. Echocardiography revealed solid 4.64.3-cm tumor mass located in close relation to the left and right atria. A magnetic resonance image of the heart demonstrated the solid tumor mass adjacent mainly to the right atrium and in part to the left atrium with an early and strong arterial uptake of the contrast medium (see arrow in Fig 1). A coronary angiogram revealed a feeding blood supply primarily by the right and also left coronary artery systems. The highly vascularized tumor was located mainly in the epicardium with infiltrative growth. The intraoperative situs showed a large, primary epicardially capsulated tumor between the right and left atria compressing the inferior vena cava and the right upper pulmonary vein. The tumor was removed en bloc after clipping and oversewing the feeding vessels of the proximal right coronary artery and the first marginal