E-page Original Images: Intrapericardial paraganglioma

A 70-year-old woman applied to our hospital with complaints of shortness of breath and fatigue. The laboratory tests and physical examination were insignificant. Contrast enhanced lung computerized tomography was performed after depiction of mediastinal enlargement at the chest X-ray. A large, strongly enhancing mass encasing major vessels arising from the heart and hardly discriminated from the atrium was seen (Fig. 1A). Magnetic resonance (MR) imaging was performed before and after contrast material administration in order to better demonstrate the anatomical origin of the mass and its relationship with the neighboring structures. On MR images, intrapericardially located mass with dimensions of 6x5 cm was detected. The borders were eas- ily discerned from the mediastinal borders. The mass encased proximal portion of ascending aorta and pulmonary trunk anteriorly and dis- placed aorta to posterior and pulmonary artery to the left. (Fig. 1B-D). After contrast material administration, intense peripheral enhancement and centrally located non-enhancing portion was seen. Surgical resec- tion was planned but only sampling for histopathological diagnosis could be made due to high vascularization and myocardial invasion of the tumor. Histopathological diagnosis was paraganglioma (Fig. 2). An 18F-fluorodeoxyglucose positron emission tomography revealed no other focus. The treatment protocol involved radiotherapy.