MEDIASTINAL PARAGANGLIOMA - A SURGICAL EXPERIENCE

Between October 1960 and January 1991, 5 male and 9 female patients (m ean age, 44 +/- 19 years) were seen at the Mayo Clinic because of medi astinal paraganglioma. Nine patients presented with hypertension. In t hese and an additional patient, the tumors were biochemically active. In 13 patients, the mediastinal mass was localized preoperatively. All patients with functioning tumors received alpha-adrenergic and beta-a drenergic blockade preoperatively. Total resection was performed in 11 patients and partial resection in 2. In 1 patient, the tumor was foun d at postmortem examination. Five lesions were grossly invasive and ni ne were noninvasive. Blood pressure returned to normal in 6 of the 8 h ypertensive patients whose tumors were totally removed. In 4, catechol amine excretion normalized as well. Tumor multicentricity occurred in 6 patients. In 7 patients, the disease took a malignant course (metast ases in 5 and progression of unresectable lesions in 2). The probabili ty of 10-year survival after resection was 50% in the group with malig nant tumors, and there were no deaths in the group with benign lesions . Analysis of the DNA cellular content showed no correlation between t he ploidy pattern and the behavior of the disease.