Functioning paraganglioma of the thoracic spine: case report
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Graham Joseph Jeffs1, Gabriel Yin Foo Lee, George Tse-Hwai Wong
1Department of Neurosurgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. jeffsyg@hotmail.com
Objective And Importance:
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.
Clinical Presentation:
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.
Intervention:
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.
Conclusion:
Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.