Multimodality imaging of a cardiac paraganglioma: A case report

Abstract

Cardiac paragangliomas (PGLs) are rare extra-adrenal tumors that arise from chromaffin cells of the sympathetic ganglia. PGLs are often diagnosed incidentally, in the absence of symptoms, or with symptoms related to cardiovascular dysfunction. Cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) can be used to accurately determine the lesion morphology and position as well as providing detailed tissue characterization. A multimodal imaging approach, not yet standardized, could be useful either in diagnosis and monitoring or in treatment planning. In the case reported here, CCT and CMR were performed to define lesion anatomy, and a reconstruction was generated using cinematic rendering (CR) to characterize the PGL angioarchitecture.

Keywords: CCT; CMR; cardiac paraganglioma; case report; neuroendocrine tumor.

Figure 1

Coronary angiogram in different oblique projections showing a large cardiac mass encasing the left coronary artery.

Figure 2

CMR acquisition (A–E): DWI b 0 and b 1,000 (A,B) and ADC map (C) showing high cellularity of the lesion; balanced gradient echo sequence in short axis and two chambers (D,E), showing morphology and extension of a PGL. CCT acquisition (F–J): axial (F,G) and oblique planes highlighting the morphology, position, and contrast of the PGL. CR reconstructions in different planes (K–O).