Surgical Treatment of Spinal Metastatic Pheochromocytoma and Paraganglioma: A Single Institutional Cohort of 18 Patients

Abstract

Study design Retrospective Cohort Study Objectives To describe surgeries and treatment outcomes of metastatic pheochromocytomas and paragangliomas (PPGLs) on the spine. Methods We reviewed a cohort of 18 patients with spinal PPGLs who were consecutively treated in our spinal center. Their clinical data was reviewed. The survival period and its relevant factors was then analyzed. Results The cohort included ten cases of pheochromocytomas and eight paragangliomas. The local pain and neurological deficits were the two most common symptoms. One third of the spinal PPGLs were diagnosed as functional tumors, arousing secondary hypertension. The imaging features were consistent with those of osteolytic lesions. The surgical strategies for the cohort included percutaneous vertebroplasty, neurological decompression and partial tumor resection, and total en-bloc resection. The postoperative courses were uneventful except 1 patient developed heart failure. The adjuvant therapies were implemented in 6 patients with 131I-MIBG, five with radiotherapy, two with chemotherapy, and 1 with target therapy. The median survival period was 39 months, and the overall survival rate of 1 year was 77.8% (14/18). The patients’ Karnofsky performance scores were positively correlated with the survival period ( P < .05). Conclusion Surgery is indicated for intractable local pain and neurological impairment in the patients with spinal PPGLs. Palliative surgical strategies, including neurological decompression and partial tumor resection, could bring fair outcomes, especially for the patients in poor physical conditions.

A Novel Technology for 3D‐Printing Artificial Vertebral Bodies for Treating Lumbar Spine Adrenal Pheochromocytoma Metastases: A Case Report and Review of the Literature

“…After the first operation of benign pheochromocytoma, 13% of the cases will relapse into benign or malignant tumors. Some studies have claimed that the 5‐year survival rate of malignant pheochromocytomas is 40% 2,9,10 . In the Remine et al .…”

“…Some studies have claimed that the 5‐year survival rate of malignant pheochromocytomas is 40%. 2 , 9 , 10 In the Remine et al . study, one group of patients with metastatic pheochromocytoma had a relatively high mortality rate within 5 years of metastasis, while another group had a maximum survival time of up to 20 years after being diagnosed with metastatic tumors.…”