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Case Reports in Surgery
Volume 2014, Article ID 308462, 4 pages
http://dx.doi.org/10.1155/2014/308462
Case Report

Successful Removal of Giant Intrapericardial Paraganglioma via Posterolateral Thoracotomy

1Department of Thoracic Surgery, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka 581-0069, Japan
2Department of Pathology, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Yao, Osaka 581-0069, Japan

Received 8 June 2014; Accepted 15 October 2014; Published 9 November 2014

Academic Editor: Giovanni Mariscalco

Copyright © 2014 Yoko Yamamoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intrapericardial paraganglioma remains a surgical challenge because of its hypervascular nature and firm adhesion to adjacent mediastinal structures. Here, we describe a 63-year-old female with a giant nonfunctioning intrapericardial paraganglioma tightly adhered to the left atrium. Marginal but complete resection of the tumor was achieved via right posterolateral thoracotomy. At the time of dissection between the tumor and the left atrial wall, we encountered massive hemorrhage leading to cardiac arrest. We were able to repair the wall laceration with minimal time under an optimal operative field, which avoids air embolism. She was discharged without complications and is currently in good health with no recurrence or metastasis for 15 months. Based on our experience, cardiopulmonary bypass should be considered, if surgeons are able to secure suitable sites for arterial and venous cannulations while right posterolateral thoracotomy is employed.