Resection of a Giant Middel Mediastinum Paraganglioma by Clamshell Incision without Cardiopulmonary Bypass

Paraganglioma is a tumor developed from paraganglia, which are groups of neuroendocrine cells located along the vascular and nerve axes of the head and neck and along the spine. These tumors are benign and still localized in more than 80% of cases. Middle mediastinal paragangliomas represent less than 1% of mediastinal tumors and grow from the superior or middle mediastinal autonomic ganglion; they mostly are non-functional and are found in older patients. The often large volume and complex location of these tumors make their surgical resection challenging forcing the surgical team to resort to cardiopulmonary bypass and practice transfection of the aortic artery. We successfully operated an 80-year-old patient by clamshell incision without bypass or arterial procedure.