title: [Malignant paraganglioma of the posterior mediastinum with 27 years follow-up].
abstract: BACKGROUND
  A costovertebral paraganglioma with a long history of recurrences and metastases is reported.
  
  
  METHODS
  The lesion is documented on histological ground and with immunocytochemistry and electron microscopy.
  
  
  RESULTS
  The patient is a 42 year old man which presented with a 5 cm axillary mass and enlarged mediastinal lymph nodes. The former lesion has been interpreted as a metastasis of paraganglioma. The patient underwent surgery because of a costovertebral paraganglioma at the age of 19 and showed locoregional metastases and a recurrence over a period of 23 years. Twenty-seven years from removal of the primitive tumor, the patient is alive and well. All the neoplasms showed identical histological features as they were composed of neoplastic elements arranged in nests surrounded by dendritic cells. Neoplastic cells immunoreacted with anti-chromogranin antiserum whereas sustentacolar cells were positive with S-100 antiserum.
  
  
  CONCLUSIONS
  The differential diagnosis between a multicentric paraganglioma a metastasis has been particularly taken into consideration. In addition, axillary tumor was distinguished from a metastatic renal cell carcinoma and melanoma. The literature regarding costovertebral paraganglioma has been also revised.
authors.affiliation: Dipartimento Clinico di Scienze Radiologiche e Istocitopatologiche, Università di Bologna.
authors.forename: L
authors.initials: L
authors.lastname: Mancini
authors.forename: F
authors.initials: F
authors.lastname: Roncaroli
mesh_terms: D000328:Adult; D001365:Axilla; D014408:Biomarkers, Tumor / Q000032:analysis; D018437:Brown-Sequard Syndrome / Q000209:etiology; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D003594:Cytoplasmic Granules / Q000737:chemistry; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008479:Mediastinal Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D009363:Neoplasm Proteins / Q000032:analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D009479:Neuropeptides / Q000032:analysis; D010235:Paraganglioma / Q000737:chemistry / Q000150:complications / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D009418:S100 Proteins / Q000032:analysis; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D009363:Neoplasm Proteins; D009479:Neuropeptides; D009418:S100 Proteins