Functioning paraganglioma of the thoracic spine: case report

• Published in: Neurosurgery Vol. 53; no. 4; p. 992
• Main Authors: Jeffs, Graham Joseph, Lee, Gabriel Yin Foo, Wong, George Tse-Hwai
• Format: Journal Article
• Language: English
• Published: United States 01.10.2003
• Subjects: Adrenergic alpha-Antagonists - therapeutic use; Catecholamines - urine; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Paraganglioma - diagnosis; Paraganglioma - pathology; Paraganglioma - physiopathology; Paraganglioma - surgery; Preoperative Care; Spinal Cord Neoplasms - diagnosis; Spinal Cord Neoplasms - pathology; Spinal Cord Neoplasms - physiopathology; Spinal Cord Neoplasms - surgery; Thoracic Vertebrae
• ISSN: 0148-396X
• DOI: 10.1227/01.neu.0000084082.08940.7f

Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma. A 53-year-old woman presented with a 10-month history of headaches, facial flushing, and palpitations associated with hypertension. Urinary catecholamine levels were markedly elevated. Magnetic resonance imaging and m-[(123)I]iodobenzylguanidine scans demonstrated an extradural tumor located within the T12 vertebra, with a significant paraspinal component. The neurological examination revealed mild hypesthesia in the right T12 dermatome. The patient underwent resection of the tumor after alpha-adrenergic receptor blockade. Grossly complete excision was achieved without neurological complications. Postoperatively, the patient was normotensive and exhibited catecholamine levels within the normal range. Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.