Extradural Dorsal Spinal Paraganglioma: A Rare Case Report and Literature Review

Abstract

Paragangliomas are neuroendocrine tumors originating from specialized cells of neural crest derivative. They are mostly found in the carotid and jugulotympanic region. Paragangliomas are extremely rare in the spine, and in literature, most cases are described as intradural extramedullary lesion in the cauda equine or filum terminale region. Extradural dorsal spine paragangliomas are even rarer, and till date, only 11 cases are reported in available literature. We describe a case of an adult woman who presented with mid dorsal region pain and sensory-motor spastic paraplegia. Imaging features were suggestive of D5 Pott's spine with epidural granulation tissue. Perioperatively, the tumor was moderately vascular and complete excision done. On HPE and IHC, diagnosis of paraganglioma was made. There was no evidence of clinical recurrence of the lesion at 6 months follow-up.

Keywords

paraganglioma - dorsal spine - Zellballen's pattern - immunohisto chemistry

• References

• 1 Faro SH, Turtz AR, Koenigsberg RA, Mohamed FB, Chen CY, Stein H. Paraganglioma of the cauda equina with associated intramedullary cyst: MR findings. AJNR Am J Neuroradiol 1997; 18 (08) 1588-1590
• 2 Oh HS, Kim TW, Park KH. Spinal paraganglioma adherent to the cauda equina. Korean J Spine 2014; 11 (04) 252-254
• 3 Cybulski GR, Nijensohn E, Brody BA, Meyer Jr PR, Cohen B. Spinal cord compression from a thoracic paraganglioma: case report. Neurosurgery 1991; 28 (02) 306-309
• 4 Yoshida A, Umekita Y, Ohi Y, Hatanaka S, Yoshida H. Paraganglioma of the cauda equina. A case report and review of the literature. Acta Pathol Jpn 1991; 41 (04) 305-310
• 5 Lerman RI, Kaplan ES, Daman L. Ganglioneuroma-paraganglioma of the intradural filum terminale. Case report. J Neurosurg 1972; 36 (05) 652-658
• 6 Jaiswal M, Bhaskar MK, Mittal RS, Ojha B. Positional hoarseness: an unusual symptom in jugular foramen mass. BMJ Case Rep 2016; 2016: bcr2016215805
• 7 Böker DK, Wassmann H, Solymosi L. Paragangliomas of the spinal canal. Surg Neurol 1983; 19 (05) 461-468
• 8 Fitzgerald LF, Cech DA, Goodman JC. Paraganglioma of the thoracic spinal cord. Clin Neurol Neurosurg 1996; 98 (02) 183-185
• 9 Noorda RJP, Wuisman PIJM, Kummer AJ, Winters HA, Rauwerda JA, Egeler-Peerdeman SM. Nonfunctioning malignant paraganglioma of the posterior mediastinum with spinal cord compression. A case report. Spine 1996; 21 (14) 1703-1709
• 10 Shin JY, Lee SM, Hwang MY, Sohn CH, Suh SJ. MR findings of the spinal paraganglioma : report of three cases. J Korean Med Sci 2001; 16 (04) 522-526
• 11 Houten JK, Babu RP, Miller DC. Thoracic paraganglioma presenting with spinal cord compression and metastases. J Spinal Disord Tech 2002; 15 (04) 319-323
• 12 Jeffs GJ, Lee GY, Wong GT. Functioning paraganglioma of the thoracic spine: case report. Neurosurgery 2003; 53 (04) 992-994 discussion 994–995
• 13 Conti P, Mouchaty H, Spacca B, Buccoliero AM, Conti R. Thoracic extradural paragangliomas: a case report and review of the literature. Spinal Cord 2006; 44 (02) 120-125
• 14 Gusmão MS, Gomes EG, Fernandes RB. et al. Paraganglioma in the spine: case report. Rev Bras Ortop 2015; 47 (02) 263-266
• 15 Moran CA, Rush W, Mena H. Primary spinal paragangliomas: a clinicopathological and immunohistochemical study of 30 cases. Histopathology 1997; 31 (02) 167-173
• 16 Boncoeur-Martel MP, Lesort A, Moreau JJ. et al. MRI of paraganglioma of the filum terminale. J Comput Assist Tomogr 1996; 20 (01) 162-165
• 17 Rumana M, Khursheed N, Vani S. Primary spinal paragangliomas: a review. Neurosurg Q 2009; 19 (03) 196-199
• 18 Rao AB, Koeller KK, Adair CF. Armed Forces Institute of Pathology.. From the archives of the AFIP. Paragangliomas of the head and neck: radiologic-pathologic correlation. Radiographics 1999; 19 (06) 1605-1632 Case Report