Paraganglioma of the Lumbar Spine: A case report and literature review

• Published in: Neuro-chirurgie Vol. 65; no. 6; pp. 387 - 392
• Main Authors: Honeyman, S.I., Warr, W., Curran, O.E., Demetriades, A.K.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.12.2019
• Subjects: Back Pain - etiology; Back Pain - surgery; Diagnosis, Differential; Humans; Lumbosacral Region; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Paraganglioma; Paraganglioma - diagnostic imaging; Paraganglioma - epidemiology; Paraganglioma - surgery; Spinal cord compression; Spinal Neoplasms - diagnostic imaging; Spinal Neoplasms - epidemiology; Spinal Neoplasms - surgery; Spinal tumor; Treatment Outcome; Paraganglioma; Spinal tumor; Spinal cord compression
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2019.05.010

Lumbar paragangliomas are rare, vascular, neuroendocrine tumors. They are notoriously difficult to diagnose radiologically and can prove challenging to manage intraoperatively, if capable of catecholamine secretion. We report the case of a 45-year-old man, who presented with a lumbar spinal paraganglioma. The patient described a 2-year history of worsening lower back pain and sciatica. Neurological examination was normal. MRI revealed a lesion at L3, with prominent vessels, compressing the cauda equina. Gross total resection (GTR) of the tumor was performed. The patient recovered well, with relief of pain and no neurological deficit. A literature search of lumbar paraganglioma cases, from January 1970 to April 2018 was carried out. Results of this review highlighted the importance of inclusion of paraganglioma as a differential diagnosis in lumbar spinal tumor and also the requirement for preoperative investigations to determine any potential secretory activity. Lumbar paraganglioma behavior is most commonly benign and rates of recurrence are low after GTR. However, long-term postoperative follow-up is crucial, due to findings of late metastatic recurrence.