Extradural paraganglioma with multiple skeletal metastases

Jindel, Rajesh; Gupta, Anshul; Mahapatra, A. K.; Bal, Chandrasekhar; Singhal, Ritu

doi:10.1259/0007-1285-65-778-938

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…Most extradural spinal PGs are metastatic (11,12,18,19), and are located commonly in the thoracic spine. However, there are some primary spinal extradural PG cases (7,8). Both cases reported here were located in the cauda equina.…”

Section: Discussionmentioning

confidence: 76%

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Lumbar intradural paragangliomas: report of two cases

Şi̇mşek¹,

Önen²,

Zerenler³

et al. 2014

Turkish Neurosurgery

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Paraganglioma (PG) is a rare tumor of the dispersed neuroendocrine system. PG derives from the embryonic sympathetic and parasympathetic nervous system. Paraganglioma is a neoplasm of the dispersed neuroendocrine system that affects a variety of anatomic sites, mainly the head and neck. It occurs commonly in the carotid body, glomus jugulare, mediastinum and retroperitoneum. Primary spinal paragangliomas are quite rare tumors. They are commonly located in the cauda equina region, and manifest their own clinical and radiological features. In this study, two cases of lumbar intradural paragangliomas are presented. Both of the tumors were totally resected with surgery and there was no evidence of recurrence or metastases during follow-up period. It was concluded that paragangliomas should be taken into consideration during the preoperative workup studies of lumbar intradural tumors.

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Section: Discussionmentioning

confidence: 76%

“…Complete surgical resection is possible in most cases. When total tumor resection is not possible, radiation treatment is recommended (8,27). Total removal of the entire tumor was achieved in our both cases and no radiation therapy was performed.…”

Section: Discussionmentioning

confidence: 99%

Lumbar intradural paragangliomas: report of two cases

Şi̇mşek¹,

Önen²,

Zerenler³

et al. 2014

Turkish Neurosurgery

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“…In this case, staging after resection of the primary tumor revealed a solitary metastasis in the vertebral body of L1. This is unusual because metastases have been reported to occur usually intradurally when the spine is involved [3,11,13,18,19]. Isolated metastatic involvement of vertebral bodies is extremely rare, and only isolated case reports have been published.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up after en bloc resection and reconstruction of a solitary paraganglioma metastasis in the first lumbar vertebral body: a case report

et al. 2011

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IntroductionParagangliomas are rare tumors that originate from the autonomic nervous system-associated paraganglia. They metastasize infrequently. Malignancy can only be demonstrated by the presence of chromaffin tissue at sites where it usually is not present, such as bone, lung or liver, or local recurrence after total resection of a primary mass. Paragangliomas within the central nervous system are usually intradural near the conus medullaris. The metastatic spread of a retroperitoneal paraganglioma to a vertebral body is extremely rare, and there are only a few cases reported in the literature.Case presentationWe report the case of a 16-year-old Caucasian girl who had undergone resection of a retroperitoneal paraganglioma that measured 15 × 11.5 × 9.5 cm. After further staging, a solitary metastatic paraganglioma was detected in the first lumbar vertebral body. After initial chemotherapy, marginal en bloc resection and reconstruction were performed followed by radiotherapy. Histologic examination of the specimen revealed that the tumor cells did not show any response to preoperative chemotherapy, which is in line with a few other reports in the literature. Ten years after operative treatment, the patient is free of complaints, very satisfied with the result and without signs of local recurrence or distant metastases.ConclusionWe recommend en bloc spondylectomy and local radiotherapy in the treatment of solitary spinal metastatic paragangliomas.

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“…The recurrence for the metastatic patient was due to incomplete removal. When removal of the entire tumor is not possible, radiation treatment is recommended (9,18). The general recommended dose is 4,000 to 4,500 cGy.…”

Section: █ Conclusionmentioning

confidence: 99%

Paragangliomas of the spine

Lu²,

Dai³

2015

Turkish Neurosurgery

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Clinical presentations and courses of spinal paragangliomas are varied, and there are no standard principles of treatment to date (1,8). In this article, we report the clinical data of 7 consecutive cases with complete medical records and followup results that were treated in our institutions, in an attempt to explore the diagnosis, treatment and prognosis. █ mATERIAl and mEThODSA retrospective analysis was performed in 7 patients with spinal paraganglioma in our hospital from October 2000 to October 2011. No patient was lost in the follow-up period. There were 6 cases of primary spinal paraganglioma and one case █ INTRODUCTION P aragangliomas are rare tumors that arise from the paraganglia cells of the neuroendocrine system and account for 0.3% of all neoplasms (2,4). More than 80% of this kind of tumor develops within or near the glomus jugulare and carotid body. Paragangliomas of spinal involvement are extremely rare. Primary spinal paragangliomas usually take the form of intradural compression of the cauda equina or intra/extradural compression of the thoracic and cervical spinal cord (1). The first case of metastatic spread of a paraganglioma to the spine was reported in 1948. So far, less than 30 cases of spinal metastases by paragangliomas have been reported in English.AIm: Paragangliomas of the spine are rare tumors. Clinical presentations and courses of spinal paragangliomas are varied, and there are no standard principles of treatment to date. The purpose of this study was to explore the diagnosis, treatment and prognosis of spinal paragangliomas. mATERIAl and mEThODS:The clinical data of 7 consecutive cases, with complete medical records and follow-up results that were treated in our institutions from October 2000 to October 2011, was retrospectively reviewed.RESUlTS: There were 6 males and 1 female with a mean age of 40 years (range, 16-61). The follow-up period ranged from 40 to 98 months (mean, 72 months). Of the 6 primary spinal paragangliomas, one lesion was in the cervical intradural extramedullary space, one in the thoracic epidural space and four in the lumbar intradural extramedullary space. All tumors were totally resected and no recurrence was detected during the follow-up period. Of the metastatic case, the lesion of the spine was located in the first lumbar epidural space and vertebra. The patients underwent surgical resection two times with radiotherapy, but the tumor recurred and the patient suffered from the paraplegia of lower limbs and urine and stool incontinence during the follow-up period. No patient died.CONClUSION: Spinal paragangliomas are rare lesions and seldom considered in the presurgical differential diagnosis due to its rarity and non-specific clinical symptoms and imaging features. Clinical follow-up was necessary to determine the outcome. Complete resection is necessary to prevent recurrence. The role of radiotherapy in the management of these lesions needs further assessment.

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Extradural paraganglioma with multiple skeletal metastases

Cited by 10 publications

References 11 publications

Lumbar intradural paragangliomas: report of two cases

Lumbar intradural paragangliomas: report of two cases

Long-term follow-up after en bloc resection and reconstruction of a solitary paraganglioma metastasis in the first lumbar vertebral body: a case report

Paragangliomas of the spine

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