Management of delayed intracranial and intraspinal metastases of intradural spinal paragangliomas.
The preferential site of extra-adrenal paragangliomas is the head and neck region. However intradural spinal paragangliomas are commonly described and are considered as benign entities. We report the case of a paraganglioma of the cauda equina followed after complete surgical removal by intracranial and intraspinal cerebrospinal fluid metastases. Seven years after the first operation, a cystic cerebellar lesion was successfully treated by surgery. During a long follow-up, four locations in the posterior fossa, a lumbar recurrence and metastatic nodules at T6 and S1-S2 level were also discovered. Radiotherapy stopped the lesions' growth and allowed improvement of the neurological status. Through a review and analysis of the literature, we discuss the management of this unusual evolution.
Thines
L
L
Department of Neurosurgery, Centre Hospitalier Régional et Universitaire, Lille, France. Laurent.Thines@wanadoo.fr
Lejeune
J P
JP
Ruchoux
M M
MM
Assaker
R
R
D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D010235:Paraganglioma / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D013904:Thoracic Vertebrae; D013997:Time Factors