• Neurosurgery · Oct 2003

    Case Reports

    Functioning paraganglioma of the thoracic spine: case report.

    • Graham Joseph Jeffs, Gabriel Yin Foo Lee, and George Tse-Hwai Wong.
    • Department of Neurosurgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. jeffsyg@hotmail.com
    • Neurosurgery. 2003 Oct 1;53(4):992-4; discussion 994-5.

    Objective And ImportanceParagangliomas 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 PresentationA 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.InterventionThe 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.ConclusionFunctioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.

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