Presentation Title

Cardiac Paraganglioma as a Rare Cause of Lower Extremity Deep Vein Thrombosis

Format

Poster

Start Date

6-11-2020 11:00 AM

End Date

6-11-2020 11:15 AM

Abstract

Cardiac Paraganglioma as a Rare Cause of Lower Extremity Deep Vein Thrombosis Stephanie Prater MD1, Robert Beecham MD1 1Diagnostic Radiology, Aventura Hospital and Medical Center Introduction: Primary cardiac tumors are very rare and paraganglioma is the rarest, constituting less than 1% of all cardiac neoplasms. Paragangliomas are extra-adrenal tumors of neural crest origin that are most notable for their potential vasoactive effects related to catecholamine release though the majority are functionally inactive. Case Description: A 60-year-old man presented with dyspnea, exercise intolerance, and right lower extremity pain and swelling of 2 weeks duration. Doppler ultrasound examination of the lower extremities revealed right popliteal DVT and CT angiography of the chest was subsequently performed to rule out pulmonary embolism; a heterogeneous, highly vascular mass in the mediastinum causing compression of the right atrium and near complete occlusion of the vena cava was discovered. Further investigation with echocardiography, MRI, and cardiac catheterization confirmed the diagnosis of right atrial mass. The patient’s DVT was felt to be the result of a low flow state caused by impaired venous return due to the size and location of the mass. The patient underwent radical surgical resection including complex reconstruction of the right atrium and superior vena cava, with histopathology confirming the diagnosis of paraganglioma. Discussion: Intra-cardiac paragangliomas arise from the chromaffin cells of the sympathetic ganglia within the atrial walls. Clinical presentation depends on their specific location and functional status. The only curative treatment for these tumors is complete surgical resection which is often complicated by the possibility of serious hemorrhage due to local invasion, rich vascularity, and the proximity of the tumors to the great vessels.

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Nov 6th, 11:00 AM Nov 6th, 11:15 AM

Cardiac Paraganglioma as a Rare Cause of Lower Extremity Deep Vein Thrombosis

Cardiac Paraganglioma as a Rare Cause of Lower Extremity Deep Vein Thrombosis Stephanie Prater MD1, Robert Beecham MD1 1Diagnostic Radiology, Aventura Hospital and Medical Center Introduction: Primary cardiac tumors are very rare and paraganglioma is the rarest, constituting less than 1% of all cardiac neoplasms. Paragangliomas are extra-adrenal tumors of neural crest origin that are most notable for their potential vasoactive effects related to catecholamine release though the majority are functionally inactive. Case Description: A 60-year-old man presented with dyspnea, exercise intolerance, and right lower extremity pain and swelling of 2 weeks duration. Doppler ultrasound examination of the lower extremities revealed right popliteal DVT and CT angiography of the chest was subsequently performed to rule out pulmonary embolism; a heterogeneous, highly vascular mass in the mediastinum causing compression of the right atrium and near complete occlusion of the vena cava was discovered. Further investigation with echocardiography, MRI, and cardiac catheterization confirmed the diagnosis of right atrial mass. The patient’s DVT was felt to be the result of a low flow state caused by impaired venous return due to the size and location of the mass. The patient underwent radical surgical resection including complex reconstruction of the right atrium and superior vena cava, with histopathology confirming the diagnosis of paraganglioma. Discussion: Intra-cardiac paragangliomas arise from the chromaffin cells of the sympathetic ganglia within the atrial walls. Clinical presentation depends on their specific location and functional status. The only curative treatment for these tumors is complete surgical resection which is often complicated by the possibility of serious hemorrhage due to local invasion, rich vascularity, and the proximity of the tumors to the great vessels.