Functional paraganglioma in the right atrium

A 39-year-old male presented to our clinic because of nocturnal intermittent palpitation for 2 years. His medical history showed a high blood pressure of 200/100 mm Hg. Transthoracic echocardiography revealed a 54×46-mm mass in the right atrium (Figure 1a, 1b). In addition, cardiac magnetic resonance imaging confirmed the tumor and highly suggested it to be a malignant tumor (Figure 1c, 1d). An almost 50-fold increase in the blood catecholamine metabolites was detected. Further, positron emission tomography/computed tomography found no other tumor. Given the symptoms and the functional intra-atrial tumor, surgical removal was agreed by our surgical team and the family. During the surgery, we found that the tumor had invaded into the right atrial wall and inter-atrial septum (Figure 1e, 1f). Following the complete removal of the tumor, we reconstructed the right atrium and inter-atrial septum with bovine pericardium. Intraoperative echocardiography showed no shunt between the atria and reflow of the pulmonary veins were clear