{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:42:27Z","timestamp":1759466547434,"version":"build-2065373602"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017957","name":"Health Commission of Guizhou Province","doi-asserted-by":"publisher","award":["GZWJKJ2020-1-111"],"award-info":[{"award-number":["GZWJKJ2020-1-111"]}],"id":[{"id":"10.13039\/100017957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>A pheochromocytoma (PPGL) in the mediastinum can originate from the paravertebral sympathetic nerve chain in the posterior mediastinum, or from the intervertebral, subclavian, coronary, pulmonary, or paravertebral paraganglia in the anterior or middle mediastinum. This case report presents the diagnosis of a large, functional paraganglioma in the posterior mediastinum, accompanied by excessive catecholamine secretion, in a 14-year-old male patient. Through multidisciplinary collaboration, radical tumor resection was performed with successful outcomes. This study systematically summarizes the standardized diagnostic pathway and key surgical techniques for this rare disease. The patient exhibited symptoms of exercise-induced retrosternal pressure and paroxysmal palpitations. A chest CT scan prior to surgery revealed a large tumor in the posterior mediastinum, measuring 8.0 \u00d7 5.6 \u00d7 7.2 cm, which was wrapping around the descending aorta. During the surgical procedure, it was demonstrated that an acute hypertensive crisis was precipitated by the presence of tumor traction and compression. Despite rigorous pharmacological intervention, blood pressure levels were highly variable (ranging from 235\/172 mmHg to 36\/26 mmHg). Subsequent pathological analysis after surgery confirmed the diagnosis of a functional paraganglioma, as indicated by strong positive CgA expression as determined by immunohistochemical staining. This case study provides a detailed account of managing a posterior mediastinal paraganglioma, emphasizing the dual challenges of diagnosis and treatment. The first challenge is definitively determining the patient\u2019s functional status through multimodal imaging combined with biomarkers. The second is optimizing an \u03b1-receptor blockade regimen and developing dynamic blood flow management strategies intraoperatively to prevent life-threatening complications.<\/jats:p>","DOI":"10.3389\/fonc.2025.1651878","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T04:11:01Z","timestamp":1759464661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary management of a rare case of a large functional paraganglioma in the posterior mediastinum in an adolescent: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Li Hang","family":"Liao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao Jun","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang Yong","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002438","article-title":"Genetics, diagnosis, management and future directions of research of phaeochromocytoma and paraganglioma: a position statement and consensus of the working group on endocrine hypertension of the european society of hypertension","volume":"38","author":"Lenders","year":"2020","journal-title":"J\u00a0Hypertens"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498","article-title":"Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline","volume":"99","author":"Lenders","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12084","article-title":"Pheochromocytoma\/paraganglioma: review of perioperative management of blood pressure and update on genetic mutations associated with pheochromocytoma","volume":"15","author":"Fishbein","year":"2013","journal-title":"J Clin Hypertens (greenwich Conn)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.02.023","article-title":"Perioperative management of pheochromocytoma","volume":"31","author":"Naranjo","year":"2017","journal-title":"J\u00a0Cardiothorac Vasc Anesth"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2015.09.006","article-title":"Pheochromocytoma and paraganglioma: genetics, diagnosis, and treatment","volume":"30","author":"Fishbein","year":"2016","journal-title":"Hematol Oncol Clin North Am"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2025-0079","article-title":"Delayed diagnosis of retroperitoneal paraganglioma in an 8-year-old boy with persistent hypertension: a case report and review of diagnostic challenges in pediatric secondary hypertension","volume":"38","author":"Pan","year":"2025","journal-title":"J Pediatr Endocrinol Metab: JPEM"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000005622","article-title":"123I-MIBG SPECT\/CT in evaluating symptomatic urinary bladder pheochromocytoma","volume":"50","author":"Algodayan","year":"2025","journal-title":"Clin Nucl Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000005808","article-title":"Increased 68 Ga-DOTATATE uptake in brown adipose tissue in a case of head and neck paraganglioma","volume":"50","author":"Dai","year":"2025","journal-title":"Clin Nucl Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.jtcvs.2020.09.100","article-title":"Management of primary cardiac paraganglioma","volume":"164","author":"Chan","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40200-016-0230-1","article-title":"Does this patient have pheochromocytoma? 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