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

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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
This report emphasizes the utility of 3,4-dihydroxy-6-(18)F-fluoro-l-phenylalanine ((18)F-FDOPA) PET scanning for diagnosis, as well as the combination of radiation therapy and alkylating chemotherapeutic agents for the treatment of this rare phenomenon. The patient was a 61-year-old woman who presented with low-back pain and was found to have an isolated L-3 intrathecal tumor on MRI. Sixteen months after gross-total en bloc resection of the paraganglioma, the patient again became symptomatic with new neurological symptoms. MRI findings revealed enhancing leptomeningeal nodules throughout the spine. (18)F-FDOPA PET/CT scan...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
Authors: Sokabe A, Mizooka M, Sakemi R, Kobayashi T, Kishikawa N, Yokobayashi K, Kanno K, Tazuma S Abstract Jugular paraganlioma is a benign, slow-growing tumor originating from the paraganglion cells and it is associated with catecholamine secretion. Paragangliomas can secrete Interleukin-6 (IL-6) and present as a systemic inflammatory syndrome; these characteristics have not been previously associated with jugular paragangliomas. A 63-year-old man with a jugular tumor in the skull base was referred to our hospital for an evaluation of pyrexia, back pain, and acute inflammation. His serum IL-6 level was elevated o...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
CONCLUSION: CEPs commonly present with mild symptoms and signs rather than the acute-onset of a flaccid paraparesis/cauda equina syndrome as seen in this case. Here, the authors review the radiological and histopathological characteristics of CEP and emphasize the role of IHC in differentiating "CEP" from the more common ependymomas. PMID: 27127702 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
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