The patient's biochemical workup revealed elevated chromogranin A, as well as elevated plasma and 24-hour urine metanephrine. Based on the biochemical profile, radiologic and nuclear scans, paraganglioma was the favored diagnosis.
The patient was referred to cardiac surgery for resection. Intraoperatively, the mass was confirmed to be within the atrioventricular groove. It was successfully resected but required repair of the right ventricle with a bovine pericardial patch and coronary artery bypass of the right coronary artery using a saphenous vein graft.
Histopathologic analysis showed that the tumor had typical features of a paraganglioma with no negative morphological features. Mitoses were not readily identified.
There has been no evidence of radiologic or biochemical recurrence since the surgery.