Subscribe to RSS

DOI: 10.1055/s-0042-1759491
Case of Conus Paraganglioma: Case Report with Review

Abstract
Paragangliomas of spine are rare neuroendocrine tumors. They are World Health Organization grade 1 tumors with common location in cauda equina and filum terminale. We report a case of conus paraganglioma. A 57-year-old lady was admitted with low back pain with radiculopathy without bowel and bladder complaints. Magnetic resonance imaging (MRI) lumbosacral spine showed well-defined round-to-oval extramedullary lesion isointense on T1 and hyperintense on T2-weighted images at the level of L1 vertebra (suggestive of) neurogenic tumor. Intraoperatively reddish-brown capsulated tumor arising from conus with extension to filum and compressing the nerve roots was seen. Gross total excision of tumor was done. Microscopic examination showed well-encapsulated cellular tumor composed of sheets, anastomosing lobules, and nests of small, oval-to-round cells interspersed with blood vessels with mild nuclear atypia and occasional mitosis. Immunohistochemistry analysis was positive for synaptophysin and chromogranin suggestive of paraganglioma. Postoperative period was uneventful. MRI of dorso-lumbar spine showed no residual tumor. Patient was asymptomatic 5 months after surgery. The clinical, radiological, and pathological features of this rare tumor entity is presented.
Publication History
Article published online:
14 April 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Miller CA, Torack RM. Secretory ependymoma of the filum terminale. Acta Neuropathol 1970; 15 (03) 240-250
- 2 Shuangshoti S, Suwanwela N, Suwanwela C. Combined paraganglioma and glioma of conus medullaris and cauda equina. J Surg Oncol 1984; 25 (03) 162-167
- 3 Singh NG, Sarkar C, Sharma MC. et al. Paraganglioma of cauda equina: report of seven cases. Brain Tumor Pathol 2005; 22 (01) 15-20
- 4 Agrawal V, Rahul M, Khan S, Vernon V, Rachana B. Functional paraganglioma: a rare conus-cauda lesion. J Surg Tech Case Rep 2012; 4 (01) 46-49
- 5 Diyora BD, Giri SA, Kotecha N, Giri D. An unusual case of conus nonfunctioning paraganglioma. J Spinal Surg 2015; 2 (04) 148-150
- 6 Murrone D, Romanelli B, Vella G, Ierardi A. Acute onset of paraganglioma of filum terminale: a case report and surgical treatment. Int J Surg Case Rep 2017; 36: 126-129
- 7 Herman M, Pozzi-Mucelli RS, Skrap M. Paraganglioma of the cauda equina: case report and review of the MRI features. Acta Univ Palacki Olomuc Fac Med 1998; 141: 27-30
- 8 Gupta R, Narayan S. Paraganglioma of the cauda equina region. J Spinal Surg 2014; 1 (04) 174-176
- 9 Kliewer KE, Cochran AJ. A review of the histology, ultrastructure, immunohistology, and molecular biology of extra-adrenal paragangliomas. Arch Pathol Lab Med 1989; 113 (11) 1209-1218
- 10 Caccamo DV, Ho KL, Garcia JH. Cauda equina tumor with ependymal and paraganglionic differentiation. Hum Pathol 1992; 23 (07) 835-838
- 11 Midi A, Yener AN, Sav A, Cubuk R. Cauda equina paraganglioma with ependymoma-like histology: a case report. Turk Neurosurg 2012; 22 (03) 353-359
- 12 Mishra T, Goel NA, Goel AH. Primary paraganglioma of the spine: a clinicopathological study of eight cases. J Craniovertebr Junction Spine 2014; 5 (01) 20-24
- 13 Khursheed N, Dhar A, Zahoor S, Rumana M, Ramzan A. Spinal paraganglioma. Pan Arab J Neurosurg 2011; 15 (01) 71-73