Incidental finding of a cardiac paraganglioma following ischemic stroke: A case report

Cardiac paragangliomas are rare neuroendocrine tumors (NETs) that may cause morbidity through mass effect, embolic events, and catecholamine excess. This case report describes a 52-year-old woman with a history of atrial fibrillation with rapid ventricular response presenting with ischemic stroke. Incidental imaging revealed an 8-cm prevascular mass abutting the left ventricle with regions of central necrosis. Urinary metanephrine testing was elevated, indicating a functional mass. Cu-64 DOTATATE PET/CT confirmed absence of distant metastases and increased radiotracer uptake along the rim of the mass, which supported the diagnosis of a NET. CT-guided percutaneous coaxial core needle biopsy confirmed the diagnosis of a paraganglioma. Upon resection, postoperative urinary metanephrine levels normalized. This report highlights the multidisciplinary approach to the management of a cardiac paraganglioma presenting after ischemic stroke.