Surgical treatment of malignant paraganglioma with spinal invasion in a juvenile patient: A case report

Rationale: Paragangliomas are rare neuroendocrine tumors that originate in specialized cells derived from the neural crest with metastasis to the thoracic spine being among the rarest forms. Here, we are presenting a detailed analysis of a case of malignant paraganglioma in the thoracic spinal region in a 14-year-old boy. Our focus is to emphasize the importance of considering malignant paraganglioma as a diagnosis and guiding the perioperative management upon surgical treatment. The management of these unique cases has yet to be well-documented. Patient concerns: A 14-year-old boy presented with a 5-month history of continuous and progressive elevated blood pressure and back pain. The patient, who had been diagnosed of malignant paraganglioma in the left posterior mediastinum for 3 months, received surgical resection of paraganglioma in the left posterior mediastinum, which had involved the left intervertebral foramen of T4. However, the tumor was not completely resected during the first operation. Diagnoses: Magnetic resonance imaging of spine and positron emission tomography-computed tomography showed spinal cord compression secondary to the epidural component of the T4 mass, with increased marrow infiltration of the left T4 intervertebral foramen, which was difficult to be removed. Postoperative pathology confirmed the diagnosis of spinal involvement of malignant paraganglioma. Interventions: The patient underwent biopsy and percutaneous vertebroplasty of T4 an...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Related Links:

CONCLUSIONS: Since the only proven treatment able to prevent further deterioration from superficial siderosis is to stop chronic bleeding into subarachnoid space, is of paramount importance to establish an early diagnosis of the source of bleeding. Cases of unexplained superficial siderosis of central nervous system should include routine spinal MRI to rule out bleeding of spinal tumor even in asymptomatic patients. Due to severity of potential deterioration caused by superficial siderosis, any tumoral lesion observed on spinal MRI even without documented sings of bleeding should be considered for resection. PMID: 329...
Source: Revista de Neurologia - Category: Neurology Authors: Tags: Rev Neurol Source Type: research
AbstractLarge adrenal tumors pose varied challenges to surgeons in terms of diagnosis, planning surgical approach, and also intra-operative difficulties in resection. The aim of this study is to discuss challenges in the management of large and difficult adrenal lesions. A retrospective analysis was done on data of all patients with large adrenal lesions/paragangliomas managed from 1 June 2016 to 30 August 2018. Forty-eight patients with adrenal lesions underwent treatment in 2  years duration. Pain in the abdomen was the most common presentation. Mean age was 34.4 years (range 2–60), female to male (23:25)...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
A 40-year-old male with no prior medical history presented to the urology clinic with the chief complaint of intermittent and worsening right inguinal pain radiating to his right testicle and right thigh with no history of trauma, fever, chills, dysuria, hematuria, or unprotected sexual activity. He reported prior history of left inguinal orchiopexy as a child. Patient denied other associated symptoms, including headaches, palpitations, diaphoresis, nausea, diarrhea, and constipation. All vital signs were within normal limits.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
Source: Journal of Gastrointestinal Cancer - Category: Cancer & Oncology Source Type: research
ConclusionWe consider surgery as primary treatment in all PG. In our experience, preoperative diagnosis is difficult and caution must be taken to perioperative course in these cases. We do not routinely perform postoperative radiation if there is a residual tumor. We regularly perform clinical and radiological follow-up, so as to be able to document recurrent cases, which have been reported even up to 30  years after primary surgical excision.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
Conclusions - 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. PMID: 31247160 [PubMed - as supplied by publisher]
Source: Neurochirurgie - Category: Neurosurgery Tags: Neurochirurgie Source Type: research
Publication date: Available online 29 May 2019Source: Journal of Clinical NeuroscienceAuthor(s): Valerio Pipola, Stefano Boriani, Stefano Bandiera, Alberto Righi, Giovanni Barbanti Bròdano, Silvia Terzi, Riccardo Ghermandi, Giuseppe Tedesco, Gisberto Evangelisti, Marco Girolami, Alessandro GasbarriniAbstractParagangliomas (PGs) are rare tumours with a reported estimated annual incidence of up to 3 per million. Spinal involvement may possible with spinal metastasis and primary extradural localizations.The aim of this paper is to evaluate clinical outcomes of surgical treatment of a rare disease that can involve the s...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Authors: Kermenli T, Azar C PMID: 31043977 [PubMed]
Source: Polish Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research
-    CLINICAL PRESENTATION&FINDINGS    57 yr male with h/o low back pain with no h/o trauma presents for MRI lumbar spine which shows – Large relatively well defined , regular, intradural, subtly&heterogeneously enhancing SOL, seen from lower L3 border to middle of body of L5 with compression of cauda equina fibers, displaying mostly soft tissue signals on all sequences / normal meningeal  enhancement, with no significant hemorrhage / fat / cystic / necrosis/ MR demonstrable calcification  components / sugarcoating / scalloping or enlargement of the posterior neural el...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs
Conclusion: Paraganglioma is a very rare malignant tumor. This tumor should be distinguished from ependymoma, meningioma and hemangioblastoma, to avoid misdiagnosis, and missed diagnosis.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
More News: Back Pain | Brain | Cancer & Oncology | Cardiovascular & Thoracic Surgery | CT Scan | Internal Medicine | Lessons | MRI Scan | Neurology | Neurosurgery | Orthopaedics | Pain | Pain Management | Paraganglioma | Pathology | PET Scan | Vertebroplasty