Mediastinal Paraganglioma: A Challenge to a Radiologist in a Non Functional Paraganglioma

Mediastinal paragangliomas are rare tumours derived from chromaffin cells (neuroectodermal cells) associated with sympathetic ganglion of the autonomic nervous system arising from two major location near paraaortic (aorticopulmonary) and paravetebral (aorticosympathetic) region. It is highly important to suspect paraganglioma whenever vascular lesion is noted in middle or posterior mediastinum on imaging. Majority of cases present with episodic palpitation, hypertention, sweating or symptomatology due to mass effect in case of non functional paraganglioma. Management is usally surgical and its a challenging due to vascular nature of lesion particularly in case of non functional paraganglioma. Imaging modality is helpful to identify feeding vessel so that preoperative embolization can be performed to minimize bleeding.