The case was reported at the Mayagüez Medical Center.
Summary of images of the presented case. Photo: Study provided by the specialist to the Journal of Medicine and Public Health.
Paragangliomas are rare and rare tumors that form near the carotid artery, along nerve pathways in the head and neck, and other parts of the body.
Although most are benign, some could become malignant and cause symptoms such as diaphoresis, tachycardia, and hypertension.
Precisely in Puerto Rico, a case was reported of a 28-year-old woman, with no significant medical history, who reported having been treated in a previous hospitalization for complications associated with a hemothorax, an accumulation of blood between the lung and the chest wall, due to which had to receive several transfusions, recounted the Dr. Ana Maria Sanchezfrom the Family Medicine residency at the Mayagüez Medical Center (MMC).
“The patient arrives at our institution seven days later, with pain in the area where the chest tube had been placed (when she was hospitalized with the hemothorax), described as acute pain radiating to the left arm and back. At the time of admission, the patient did not have difficulty breathing, ”she said, adding that other types of discomfort were also ruled out.
“An intravenous contrast-enhanced CT showed a loculated effusion with a possible hematoma and pseudoaneurysm regarding an intercostal artery. A sonogram showed a loculated effusion, but a thoracentesis could not be performed. The next day a CT angiography is performed where a round paraspinal lesion is observed in the lower left hemithorax, between vertebrae T10 and T11, with apparent communication with an intercostal artery that could represent a pseudoaneurysm”, he added.
He reported that then the young woman underwent a left exploratory thoracotomy in the operating room with complete decortication of the lung and left mediastinum, with a recession of a mediastinal mass.
“Biopsy samples and pathological samples showed a paraganglioma with a hemorrhagic capsule with a hemorrhagic arteriovenous malformation. The patient had a successful surgical resection, as well as her hospital recovery,” she confirmed.
“To our knowledge, this is the first case of spontaneous hemothorax due to a non-functional mediastinal paraganglioma in Puerto Rico in such a young woman. In recent years, only three cases of paraganglioma ruptures resulting in a hemothorax have been reported, this being the fourth reported so far in the world,” she concluded.
See the case presentation here: