Acute onset of paraganglioma of filum terminale: A case report and surgical treatment

Murrone, Domenico; Romanelli, Bruno; Vella, Giuseppe; Ierardi, Aldo

doi:10.1016/j.ijscr.2017.05.016

Cited by 16 publications

(32 citation statements)

References 17 publications

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“…1 The literature reports an extremely low recurrence rate, sometimes occurring 9 years after surgery, 1 and it is estimated that between 1 and 4% can recur following gross total removal. 5 This supports the need for prolonged observation due to the slow growing nature of the tumor. With subtotal resection, 10% of cauda equina paragangliomas will recur 1 year following surgery, which is why radiotherapy is recommended after a subtotal resection.…”

Section: Clinical Featuresmentioning

confidence: 63%

“…3 No significant correlation was observed between the duration of symptoms and tumor dimension. 5 In the literature, there are only two described cases of an acute flaccid paraparesis/cauda equine syndrome secondary to an intratumoral hemorrhage. 5 These lesions are commonly encountered at the 4 th and 5 th decades of life, with a male predominance, and they are sporadic neoplasms, 5 although $ 1% of cases are autosomal dominant.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Extra-adrenal paragangliomas can arise anywhere in the sympathetic and parasympathetic chain of ganglia, 1 and occur commonly ($ 90% 3 ) in the neck and head region (mainly from the carotid bodies or glomus jugulare 4 predominantly of parasympathetic nature 1 ). In the CNS, they can be found at several sites such as the sella turcica, the cavernous sinus, the pineal gland, the pituitary gland, the cerebellopontine angle and the petrous ridge, 5 but more often at the cauda equina and filum terminale region, 6 where they account for between 2.5 and 3.8% of the total tumor cases of that region. 5 The mean age of presentation is around between 40 and 60 years old with a slight male predominance.…”

Section: Introductionmentioning

confidence: 99%

“…In the CNS, they can be found at several sites such as the sella turcica, the cavernous sinus, the pineal gland, the pituitary gland, the cerebellopontine angle and the petrous ridge, 5 but more often at the cauda equina and filum terminale region, 6 where they account for between 2.5 and 3.8% of the total tumor cases of that region. 5 The mean age of presentation is around between 40 and 60 years old with a slight male predominance. 5 They are histologically characterized by an arrangement of chief cells with an abundance of neurosecretory granules, placed in lobules surrounded by sustentacular cells, 1 designated as a Zellballen pattern.…”

Section: Introductionmentioning

confidence: 99%

“…5 The mean age of presentation is around between 40 and 60 years old with a slight male predominance. 5 They are histologically characterized by an arrangement of chief cells with an abundance of neurosecretory granules, placed in lobules surrounded by sustentacular cells, 1 designated as a Zellballen pattern.…”

Section: Introductionmentioning

confidence: 99%

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Gangliocytic Paraganglioma of the Filum Terminale. A Rare Entity

Tavares

Costa

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Paragangliomas are rare, benign and slow-growing neuroendocrine tumors that can arise from the adrenal medulla (85–90%) or from the extra-adrenal paraganglia.In the central nervous system (CNS), they can be found at several sites, but more often at the cauda equina and filum terminale region, where they account for between 2.5 and 3.8% of total tumor cases of that region. There are only 8 cases described in the literature that mention the presence of the gangliocytic variant of this entity at the filum terminale.We present the case of a 41-year-old man with chronic lumbar pain refractory to medical treatment, without any associated neurological deficits. Magnetic resonance imaging (MRI) revealed an intradural, extramedullar oval lesion with regular contours and homogeneous caption of contrast at L1 level.He was submitted to surgical treatment, with complete resection of the lesion. The histological analysis revealed a gangliocytic paraganglioma of the filum terminale. At 5 years of follow-up, he remains asymptomatic and without any signs of relapse.These are lesions with an overall good prognosis with gross total resection. Although the recurrence rate is extremely low, prolonged observation is recommended due to the slow-growing nature of the tumor, being estimated that between 1 and 4% can recur even after gross total removal.

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Section: Clinical Featuresmentioning

confidence: 63%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Gangliocytic Paraganglioma of the Filum Terminale. A Rare Entity

Tavares

Costa

2020

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Myxopapillary Ependymoma and Rare Tumors

Bruckbauer

Hines

Perez

et al. 2020

Tumors of the Spinal Canal

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Paraganglioma of the cauda equina: a tertiary centre experience and scoping review of the current literature

et al. 2021

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Cauda equina paragangliomas are rare benign extra-adrenal neuroendocrine tumours arising from the neural crest cells associated with autonomic ganglia. These tumours are often mistaken preoperatively for ependymomas or schwannomas. Patients present with axial or radicular pain with or without neurological deficits. Recurrence, secretory features and length of follow-up are controversial. We conducted a retrospective cohort study of paraganglioma through searching a prospectively maintained histopathology database. Patient demographics, presentation, surgery, complications, recurrence, follow-up and outcome between 2004 and 2016 were studied. The primary aim was to collate and describe the current evidence base for recurrence and secretory features of the tumour. The secondary objective was to report outcome and follow-up strategy. A scoping review was performed in accordance with the PRISMA-ScR Checklist. Ten patients were diagnosed (M:F 7:3) with a mean age of 53.6 ± 5.1 (range 34–71 years). MRI scans revealed intradural lumbar enhancing lesions. All patients had complete microsurgical excisions without adjuvant therapy with no recurrence with a mean follow-up of 5.1 ± 1.4 years. Tumours were attached to the filum terminale. Electron microscopic images demonstrated abundant neurosecretory granules with no evidence of catecholamine production. A total of 620 articles were screened and 65 papers (including ours) combining 121 patients (mean age 48.8 and M:F 71:50) were included. The mean follow-up was 3.48 ± 0.46 (range 0.15–23 years). Back pain was the most common symptom (94%). Cure following surgery was achieved in 93% of the patients whilst 7% had recurrence. Total resection likely results in cure without the need for adjuvant therapy or prolonged follow-up. However, in certain situations, the length of follow-up should be determined by the treating surgeon.

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Acute onset of paraganglioma of filum terminale: A case report and surgical treatment

Abstract: HighlightsA very rare case of paraganglioma of filum terminale is described.Clinical and radiological features of spinal paraganglioma are listed.Surgical management of paraganglioma of filum terminale is discussed.

Cited by 16 publications

References 17 publications

Gangliocytic Paraganglioma of the Filum Terminale. A Rare Entity

Gangliocytic Paraganglioma of the Filum Terminale. A Rare Entity

Myxopapillary Ependymoma and Rare Tumors

Paraganglioma of the cauda equina: a tertiary centre experience and scoping review of the current literature

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