We describe the case of a 52-year-old woman with a non-functional middle mediastinal paraganglioma. Radiologic diagnosis of paraganglioma was confirmed by multidetector computed tomography and 18F-fluorodeoxyglucose positron-emission tomography, without biopsy. Surgical resection was performed via a median sternotomy, and cardiopulmonary bypass was required for complete resection of the tumor because of invasion to the intrapericardial pulmonary artery. Preoperative pathological diagnosis of mediastinal paraganglioma by biopsy is dangerous due to bleeding, and should be avoided.
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