Table 1.
Gender, agea (years) |
F/U (years) |
Mutation | Biochemistry (fold normal) |
Presenting symptoms |
Primary mediastinal tumor |
Other PGL/Pheo |
Therapy | Outcome | |
---|---|---|---|---|---|---|---|---|---|
1 | F, 18 | 7 | SDHB, R242H | NM (4×) | Hypertension, palpitations, chest pain | T4 vertebral body (2.5 cm), recurrent disease | No | Thoracotomy, XRT | Five years to meta spine, psoas |
2 | F, 60 | 1 | SDHB, G96D | NM (11×) | Chest pain, upper back pain, weight loss, hypertension | T5–T7 vertebral body (7.5 cm), epidural space, thoracic wall, paraspinal musculature | No | Surgical removal | Stable disease |
3 | M, 25 | 7 | SDHB, R46X | Normal | Chest pain | Posterior mediastinal mass, left paraspinal T2–T3 (3.5 cm) | No | Surgery paraspinal mass, XRT lobectomy, thoracic corpectomy, decompression, fixation T1–T5 | Four years to meta lung, superior mediastinum, spine, sternum, scapula 6 years to meta left ischium, T3 and T4 |
4 | M, 45 | 9 | SDHD, c.170-1 G>T |
NM (2.6×) | Weakness, palpitations, headaches, hypertension | Middle mediastinal mass (6 cm) with compression right main pulmonary artery | HNP | Embolization, partial resection | One year to recurrent disease, meta lung, subcarinal lesion, proximal tibia |
5 | M, 26 | 4 | SDHB, R46Q | Normal | Low back pain, hypertension | Left superior mediastinum (15.6 cm) right superior paratracheal region inferior right paratracheal lymph nodes | PGL abdomen | Surgery abdominal mass six cycles etoposide/-cisplatin octreotide | Necrotic mass L4, extending in pelvis, 1 year to meta lesions L3 and L4 and lymph nodes |
6 | M, 19 | 19 | SDHD, L20C fsX66 |
NM (2×) | Hemodynamic instability during HNP surgery | Paratracheal mass (2 cm) | HNP Pheo | Carotid body removal right, adrenalectomy right, XRT (HNP), 12 cycles CVD, 131I-MIBG-therapy | Fifteen years to recurrence to mediastinum. Meta left ilium |
7 | F, 36 | 6 | SDHB, R46X | NM (3.5×) DA (1.9×) | Chest discomfort, hypertension, palpitations, pre-syncope associated with urination | Posterior mediastinal mass next to esophagus, posterior wall left atrium (2.9 cm) | PGL bladder | Partial cystectomy, re-operation (negative), surgery mediastinal PGL | Stable disease |
8 | F, 50 | 6 | SDHD, P81L | Normal | Upper respiratory symptoms, new-onset hypertension | Aorto-pulmonary window, left and right hilus (3.3 cm), pulmonary nodules | HNP | Pending | Meta lung, mediastinum, 6 years later being evaluated for new-onset hypertension |
9 | M, 41 | 1 | SDHD, D92Y | VMA (1.3×)b DA (1.1×)b | Excessive perspiration | Two masses in aorto-pulmonary window (1 cm) | HNP | Watch-and-wait | Stable disease |
10 | M, 18 | 1 | SDHB, c.286+2 T>A |
NM (10×) | Hypertension | Mass in posterior mediastinum (9 cm), growth into T5 | No | Surgery (incomplete) | Stable disease |
Mean (range) | 34 (18–60) | Primary tumor: 5.3 cm (1–15.6) |
F/U, follow-up; NM, normetanephrine; DA, dopamine; VMA, vanillyl mandelic acid; T, thoracic; L, lumbar; XRT, radiotherapy; Meta, metastasis; CVD, dacarbazine; HNP, head and neck paraganglioma; PGL, paraganglioma; Pheo, pheochromocytoma.
Age at diagnosis.
Urine measurement.