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Intraosseous sacral paraganglioma with extradural extension: case report.
Acta Neurochir (Wien). 2010 Mar; 152(3):475-80.AN

Abstract

BACKGROUND

Paragangliomas are tumors that arise from the paraganglion system, which is a component of the neuroendocrine system. Approximately 10% are located in the extra-adrenal paraganglion system. Paragangliomas of the spine, however, are rare. They usually present as an intradural tumor in the cauda equina. There are only three reports of primary intraosseous paragangliomas of the sacrum.

CASE DESCRIPTION

A 69-year-old man presented with low back pain and urinary incontinence. Imaging revealed a large intraosseous mass at S2, S3 and S4. Surgical resection was accomplished through a posterior midline incision exposing the spine from L5 to the coccyx. The tumor was located in the extradural space. It was friable, grayish and bleeding. Total tumor removal was performed, with normal bone margins. Follow-up at 2 years showed complete resolution of the preoperative symptoms and no evidence of local recurrence.

CONCLUSION

Although rare, the possibility of paraganglioma should be included in the differential diagnosis of sacral tumors. The majority of the spinal paragangliomas are benign, slowly growing tumors with low proliferative activity. Despite these characteristics, local recurrence has been reported in cases of both macroscopically total and subtotal resection. Postoperative radiation therapy for patients with incomplete excision may not prevent recurrence, so gross tumor removal should be the goal of surgery.

Authors+Show Affiliations

Department of Neurosurgery, Universidade de Caxias do Sul, Caxias do Sul, Brazil. asdrubal@doctor.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19730780

Citation

Falavigna, Asdrubal, et al. "Intraosseous Sacral Paraganglioma With Extradural Extension: Case Report." Acta Neurochirurgica, vol. 152, no. 3, 2010, pp. 475-80.
Falavigna A, Righesso O, Volquind D, et al. Intraosseous sacral paraganglioma with extradural extension: case report. Acta Neurochir (Wien). 2010;152(3):475-80.
Falavigna, A., Righesso, O., Volquind, D., Salgado, K. B., & Teles, A. R. (2010). Intraosseous sacral paraganglioma with extradural extension: case report. Acta Neurochirurgica, 152(3), 475-80. https://doi.org/10.1007/s00701-009-0362-x
Falavigna A, et al. Intraosseous Sacral Paraganglioma With Extradural Extension: Case Report. Acta Neurochir (Wien). 2010;152(3):475-80. PubMed PMID: 19730780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraosseous sacral paraganglioma with extradural extension: case report. AU - Falavigna,Asdrubal, AU - Righesso,Orlando, AU - Volquind,Daniel, AU - Salgado,Karina Bueno, AU - Teles,Alisson R, PY - 2008/07/02/received PY - 2009/03/31/accepted PY - 2009/9/5/entrez PY - 2009/9/5/pubmed PY - 2010/6/15/medline SP - 475 EP - 80 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 152 IS - 3 N2 - BACKGROUND: Paragangliomas are tumors that arise from the paraganglion system, which is a component of the neuroendocrine system. Approximately 10% are located in the extra-adrenal paraganglion system. Paragangliomas of the spine, however, are rare. They usually present as an intradural tumor in the cauda equina. There are only three reports of primary intraosseous paragangliomas of the sacrum. CASE DESCRIPTION: A 69-year-old man presented with low back pain and urinary incontinence. Imaging revealed a large intraosseous mass at S2, S3 and S4. Surgical resection was accomplished through a posterior midline incision exposing the spine from L5 to the coccyx. The tumor was located in the extradural space. It was friable, grayish and bleeding. Total tumor removal was performed, with normal bone margins. Follow-up at 2 years showed complete resolution of the preoperative symptoms and no evidence of local recurrence. CONCLUSION: Although rare, the possibility of paraganglioma should be included in the differential diagnosis of sacral tumors. The majority of the spinal paragangliomas are benign, slowly growing tumors with low proliferative activity. Despite these characteristics, local recurrence has been reported in cases of both macroscopically total and subtotal resection. Postoperative radiation therapy for patients with incomplete excision may not prevent recurrence, so gross tumor removal should be the goal of surgery. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/19730780/Intraosseous_sacral_paraganglioma_with_extradural_extension:_case_report_ L2 - https://dx.doi.org/10.1007/s00701-009-0362-x DB - PRIME DP - Unbound Medicine ER -