2 research outputs found
Paraganglioma of the cauda equina region
BACKGROUND CONTEXT: Cauda equina paragangliomas (CEPs) are rare neuroendocrine tumors.
The difficulty in differential diagnosis with other tumors of this region may be misleading for
surgical planning and prognostic expectations.
PURPOSE: To report on a rare case of CEP and review the most current information regarding the
diagnosis, treatment options, and outcomes.
STUDY DESIGN: Case report and literature review.
PATIENT SAMPLE: One patient affected by CEP.
METHODS: We report on a 33-year-old woman with a 2-month history of worsening low back
pain, aggravated by sitting, bending, and coughing. Neurological examination revealed normal
power and muscular tone, no sensory or sphincter abnormality, and normal reflex. Magnetic resonance
imaging of the lumbar spine demonstrated an intradural extramedullary lesion at L3, with
homogeneous contrast enhancement and hypointense punctate foci. The patient underwent an L3
laminectomy and tumor removal. Relevant articles covering CEPs from 1970 to the present were
reviewed.
RESULTS: The histopathological examinations described paraganglioma features. The postoperative
coursewas uneventful, and all the symptoms resolved, with no tumor recurrence after 3 years’ follow-up.
CONCLUSIONS: Cauda equina paragangliomas are rare, benign, and slow-growing tumors. Except
for its secreting tumor characteristics, preoperative CEP diagnosis is very difficult.Magnetic resonance
imaging is important andmay suggest specific radiological features for these tumors; however, these are
only relative, and it is rare that diagnosis ismade before surgery.Diagnosis is established by histological
examination and electron microscopy, and immunohistochemical techniques must be used to achieve a
correct diagnosis. Cauda equina paragangliomas arewell-encapsulated tumors that may be cured by surgery
alone, whereas radiotherapy is reserved for incompletely resected tumors. Overall, prolonged postoperative
observation is mandatory because of the slow tumor evolution and the possibility of tumor
relapse even up to 30 years after surgery