Surgery of thoracic paragangliomas. About 9 cases

Background: Paragangliomas are rare tumors with a slow progress representing difficulties in diagnosis and treatment. Thoracic location is exceptional. Methods: Our aim is to study this rare entity from a series of 9 thoracic paragangliomas (PG) and demonstrate the benefits of surgery. Results: Nine patients (5 men / 4 women) with a mean age of 42 year-old (range:5-17 years) were operated for thoracic PG. The majority of patients were symptomatic. The main symptoms were chest pain and hemoptysis. The predominant radiological aspect was that of a posterior hypervascularized mediastinal mass in 5 cases, a balloon release in 2 cases and a left lower lobe mass in 2 cases. Fibroscopy was normal in the majority of cases. Two patients had associated extrathoracic PGs (upper limb). Tumor markers were negative in all 9 cases. Patients were operated by Video-assissted thoracic surgery (2) or left posterolateral thoracotomy (6). Five patients had complete tumor resection. For one patient the resection was deemed impossible, he had a diagnostic biopsy by mediastinoscopy. Two patients had a lower left lobectomy associated in one case with a lingulectomy and with tumor resection in the other case. The surgical follow-up was simple for all patients. The two patients who had a complete resection had a survival of 6 and 8 months respectively. Non-metastatic patients who had R0 resection had prolonged survival. Conclusion: mediastinal PGs are suspected on the highly vascular aspect of the tumor on CTKey words: chest, mediastinal, tumor. The treatment of choice of thoracic PG is a surgical resection R0.