Pediatric paraganglioma of the posterior mediastinum

Abstract Rationale: Paraganglioma is rare in children and most pheochromocytomas originate in the adrenal gland. Patient concerns: The clinical characteristics, diagnosis, and managements in a 9-year-old boy who presented with vomiting and occasional headache with a blood pressure of 210/170 mm Hg was retrospectively reviewed. CT scan of the chest revealed a 7 × 5-cm-sized soft tissue mass in the left paraspinal area. Biochemical reports revealed elevated levels of serum norepinephrine, urine norepinephrine, urine dopamine, and serum neuron specific enolase. Diagnoses: The immunohistochemical studies suggested that the tumor was a paraganglioma of the posterior mediastinum. Interventions: The patient underwent mass resection with thoracotomy. Before operation, the patient was prepared by orally administering captopril, propranolol hydrochloride, and phenoxybenzamine. Body fluid volume was also prepared by vein and mouth in 3 days. Outcomes: The patient was followed up postoperatively for 1 year without recurrence. Lessons: We should be highly vigilant the pediatric tumor of the posterior mediastinum with vomiting and headache as the first clinical manifestation.