A 57-year-old lady with a history of familial paraganglioma syndrome type 4 with mutation in the succinate dehydrogenase complex, subunit B gene, had a nonfunctioning middle mediastinal paraganglioma. She also had a pituitary macroadenoma with elevated serum prolactin levels. Surgical excision of the highly vascular mediastinal tumor was performed after preparing the patient preoperatively with alpha blockers and strictly monitoring her blood pressure and blood sugar levels.
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