Sudden death in a child due to an intrathoracic paraganglioma

A 12-year-old boy under treatment for asthma was found dead in his home. Th e autopsy revealed a large posterior mediastinal mass that, completely comp ressed the upper lobe of the right lung and the associated ah-ways. This ma ss extended from the right costovertebral sulcus into the thoracic spinal c anal through the spinal foremen and compressed the spinal cord. It was loca ted in the epidural space and was adherent to a nerve root. The histologic and immunocytochemical features were that of a paraganglioma. Although neur ogenic tumors are the most common posterior mediastinal masses in the pedia tric population, paragangliomas are rare, and spinal involvement has not be en described in children. In addition, sudden death has not been reported i n association with any of the 13 cases of posterior mediastinal paraganglio ma described in the literature as involving the spine. This case illustrate s an unusual cause of sudden death in a pediatric patient due to a benign n eoplasm.