Right Ventricular Paraganglioma Mimicking Coronary Artery Aneurysm: A Diagnostic Conundrum.

backgroundParagangliomas are rare neuroendocrine tumors arising from chromaffin cells, often associated with excess catecholamine production. Cardiac paragangliomas are particularly uncommon, accounting for <1% of all cardiac tumors. CASE SUMMARY: We report a case of a right ventricular mass that was initially misidentified as a pericardial cyst on imaging but was ultimately diagnosed as a benign paraganglioma deriving from hereditary paraganglioma and pheochromocytoma syndrome after further diagnostic evaluation and treatment. DISCUSSION: This case highlights how rare pathologies may mimic other conditions, emphasizing the complexity and importance of a thorough diagnostic work-up in identifying cardiac paragangliomas. TAKE-HOME MESSAGES: Cardiac paragangliomas are exceptionally rare tumors that can mimic more common cardiac pathologies, making diagnosis challenging. Multimodal evaluation and broad differential diagnosis are essential in evaluating cardiac masses, especially when initial findings are inconclusive or suggest alternative diagnoses.