Chemodectoma of an aortic body

Aorticopulmonary paraganglioma and gastric leiomyoblastoma in a young woman

The 16th report of a patient with "Carney's triad" is presented. The triad consists of an extra-adrenal paraganglioma, gastric leiomyoblastomas and a pulmonary chondroma. The diagnosis is made by discovery of the presence of at least two of these individually rare tumors. The patient described as 15 year old girl who presented with a pericardial effusion caused by an invasive mediastinal paraganglioma. She was subsequently found to have multiple gastric leiomyoblastomas. The leiomyoblastomas have been resected. The paraganglioma was unresectable, and the patient underwent sequential radiation therapy and chemotherapy without response. Concomitant 5-fluorouracil chemotherapy with radiation resulted in an objective regression of tumor mass.

Aortico-pulmonary paraganglioma: report of a case with ultrastructural study and review of the literature

The light microscopic and ultrastructural features of an aortico-pulmonary paraganglioma (A-PP) are presented. The tumor was characterized by organoid clustering of neoplastic chief cells to form Zellballen. Argyrophilic granules were demonstrated within chief cell cytoplasm using a modified Grimelus technique. Ultrastructurally, three distinct cell types were present within the tumor: endothelial cells, pericytes and neoplastic chief cells. Membrane-bound neurosecretory granules were present and measured 100 to 2000 nm in diameter. "Light" and "dark" chief cells were less distinct than previously reported in other head and neck paragangliomas. Analysis of the 36 documented A-PP reported in the English literature reveals that the tumor has been either incompletely excised or has been considered unresectable in one-third of the cases. The reported surgical mortality is 9%, or approximately equal to the incidence of malignant behavior. The treatment of choice is surgical resection but when this is not possible, radiation may be a useful adjunct in therapy.

Intrathoracic chemodectoma with multiple localisations

In 1958 a mediastinal tumour was discovered in an asymptomatic woman with a history of vomiting and an oesophageal anomaly which had not been treated. A tumour of the anterosuperior mediastinum in relation to the aortic arch was extirpated and proved to be a chemodectoma or non-chromaffin paraganglioma. At subsequent follow-ups the mediastinum was never normal and the heart size progressively increased, the oesophageal anomaly remaining unchanged. A small opacity appeared in the left lung in 1974. An operation performed in 1975 revealed an osteochondroma in the lung, pericarditis, and an intrapericardial chemodectoma. The oesophagus was not explored. An intrathoracic chemodectoma is rare. The importance of angiography in its diagnosis is emphasised. Malignant degeneration is seldom observed. Therapy is surgical, the tumour being radioresistant. The possibility to be considered in our patient was either relapse of the tumour with degeneration or multiple localisations of the tumour.

Intrathoracic carotid-body tumour (chemodectoma)

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