Surgery of thoracic paragangliomas
Hazem Zribi1, amina abdelkbir1, Imen Bouassida1, Mahdi Abdennadher1, Sarra Zairi1, Hanen Smadhi2, Sarra Maazaoui3 and Adel Marghli1
1Thoracic and cardiovascular surgery department of Abderrahmene Mami Hospital, ARIANA, Tunisia, 2Pneumology Ibn Nafiss Department of Abderrahmene Mami Ariana Hospital, ARIANA, Tunisia, 3Pneumology Department of Charles Nicolle Hospital , TUNIS, Tunisia
Background: Paragangliomas are rare tumors with a slow progress representing difficulties in diagnosis and treatment. Thoracic location is exceptional.
Methods: Our aim is to study this rare entity from a series of 9 thoracic paragangliomas (PG) and demonstrate the benefits of surgery.
Results: Nine patients (5 men / 4 women) with a mean age of 42 year-old (range:5-17 years) were operated for thoracic PG. The majority of patients were symptomatic. The main symptoms were chest pain and hemoptysis.
The predominant radiological aspect was that of a posterior hypervascularized mediastinal mass in 5 cases, a balloon release in 2 cases and a left lower lobe mass in 2 cases. Fibroscopy was normal in the majority of cases. Two patients had associated extrathoracic PGs (upper limb). Tumor markers were negative in all 9 cases.
Patients were operated by Video-assissted thoracic surgery (2) or left posterolateral thoracotomy (6).
Five patients had complete tumor resection. For one patient the resection was deemed impossible, he had a diagnostic biopsy by mediastinoscopy. Two patients had a lower left lobectomy associated in one case with a lingulectomy and with tumor resection in the other case.
The surgical follow-up was simple for all patients. The two patients who had a complete resection had a survival of 6 and 8 months respectively. Non-metastatic patients who had R0 resection had prolonged survival.
Conclusion: mediastinal PGs are suspected on the highly vascular aspect of the tumor on CTKey words: chest, mediastinal, tumor. The treatment of choice of thoracic PG is a surgical resection R0.
Sumber : http://erj.ersjournals.com/content/50/suppl_61/PA2057
PDPI Surakarta. 05/02/18.
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