Functioning paraganglioma of the cervical spine

Extradural paraganglioma of the cervical spine is rarely seen. Few reports of this functioning disorder appear in the literature. A 29-year-old woman presented with a 1-year history of left shoulder pain and occasional transitional dizziness. This is the first case of a functioning cervical spinal paraganglioma with symptoms of catecholamine excess throughout the operation. A mass in the neck region was discovered by the patient 2 months prior to hospital admission. Physical examination revealed an egg-shaped soft and unflexible mass with no clear boundary in the anterior left part of the neck. Neither sensory disturbance nor motor weakness was evident in the upper and lower extremities. Laboratory studies were normal. Both computed tomography and magnetic resonance imaging implied neurilemmoma. Embolization of the branches supplying the mass was taken to reduce perioperative bleeding complications 1 day preoperatively. The patient demonstrated frequent hypertensive spikes with tumor handling. The blood pressure changed between 80/40 mm Hg and 200/105 mm Hg throughout the surgery. The tumor was dissected successfully from the paraspinal tissues, followed by spinal cord decompression of C4 to C6, C5 corpectomy, anterior column reconstruction, and anterior internal fixation with a plate. The histopathological examination yielded a postoperative diagnosis of paraganglioma. Diagnosis and treatment of this rare case require comprehensive perioperative management and meticulous surgical excision.