Zhonghua Nei Ke Za Zhi. 2026 Sep 1;65(9):1010-1015. doi: 10.3760/cma.j.cn112138-20260206-00080.
ABSTRACT
Paraganglioma (PGL) are rare, catecholamine-secreting neuroendocrine neoplasms arising from the adrenal medulla or the extra-adrenal paraganglionic system. Excessive secretion of catecholamines by PGL can induce myocardial damage, leading to catecholamine-induced cardiomyopathy (CICM). Some CICM presents morphologically as a dilated cardiomyopathy (DCM) phenotype. Its clinical identification and differential diagnosis are highly challenging, necessitating a comprehensive evaluation that integrates biochemical testing and multimodality imaging. Treatment strategies require a precise balance among endocrine regulation, heart failure management, and tumor intervention, relying heavily on multidisciplinary team collaboration. This article reports a case of PGL-associated CICM presenting with DCM and reviews the clinical diagnostic and therapeutic essentials as well as recent research progress regarding this condition. This case suggests that brown adipose tissue activation on 18F-FDG PET/CT may serve as a key clue to catecholamine excess; in patients with unexplained DCM/heart failure with reduced ejection fraction plus a retroperitoneal mass, nocturnal hypertension, or hypermetabolic symptoms, screening for PGL should be initiated promptly, followed by a perioperative pathway integrating α-blockade, volume optimization, delayed β-blockade, and guideline-directed anti-remodeling therapy for heart failure.
PMID:42733268 | DOI:10.3760/cma.j.cn112138-20260206-00080