Paraganglioma of the cauda equina region: Report of six cases and review of the literature

• Published in: Neuro-chirurgie Vol. 58; no. 6; pp. 341 - 345
• Main Authors: Mathon, B, Carpentier, A, Clemenceau, S, Boch, A-L, Bitar, A, Mokhtari, K, Adam, C, Dainese, L, Galanaud, D, Kalfon, F, Cornu, P
• Format: Journal Article
• Language: French; English
• Published: France Elsevier Masson 01.12.2012
• Subjects: Adult; Aged; Cauda Equina - pathology; Cauda Equina - surgery; Computer Science; Data processing; Diagnosis, Differential; Electrodiagnosis - methods; Female; Follow-Up Studies; Humans; Intraoperative Complications - prevention & control; Low Back Pain - etiology; Magnetic Resonance Imaging; Male; Medical Imaging; Middle Aged; Monitoring, Intraoperative - methods; Neoplasm Invasiveness; Neurilemmoma - diagnosis; Paraganglioma - complications; Paraganglioma - diagnostic imaging; Paraganglioma - pathology; Paraganglioma - surgery; Peripheral Nerve Injuries - prevention & control; Peripheral Nervous System Neoplasms - complications; Peripheral Nervous System Neoplasms - diagnostic imaging; Peripheral Nervous System Neoplasms - pathology; Peripheral Nervous System Neoplasms - surgery; Polyradiculopathy - etiology; Radiography; Retrospective Studies; Spinal Nerve Roots - pathology; Spinal Nerve Roots - physiopathology; Spinal Nerve Roots - surgery; Urinary Incontinence, Stress - etiology
• ISSN: 0028-3770; 1773-0619
• DOI: 10.1016/j.neuchi.2012.05.010

Paragangliomas of the cauda equina are rare tumors. The standard treatment is surgical resection. Our study aims to compare our clinical, radiological, prognostic data to the literature and to offer management and follow-up recommendations. In this retrospective study, six patients with paraganglioma of the cauda equina region were treated. Symptoms included radicular nerve pain and low back pain with occasional sphincter dysfunction and motor deficit. MRI showed well-circumscribed lesions with homogeneous enhancement following gadolinium injection. Treatment involved complete surgical resection of the tumor under electrophysiological control. In addition to the characteristics of the tumor, we assessed operating results as well as postoperative morbidity and follow-up. All patients had complete removal of the tumor, which required in most cases the resection of the carrying root. The intervention allowed a regression of the initial symptoms, with possible postoperative regressive sphincter disorders. Clinical and radiological follow-up (19 months on average), showed no tumor recurrence. The reference treatment of these tumors is complete surgical resection, usually requiring the sacrifice of the carrying nerve root. Intra-operative nerve roots stimulation is recommended to reduce the risk of motor deficit linked to this radical treatment. A long-term clinical and radiological follow-up is recommended.