title: Catecholamine-secreting paraganglioma of the thoracic spinal column:  report of an unusual case and review of the literature.
abstract: BACKGROUND
  Paragangliomas are rare tumors of neuroendocrine origin that arise from paraganglionic tissue of the extrachromaffin cell system. These lesions may be seen at various sites along the neuraxis. Primary thoracic paragangliomas have rarely been reported in the literature, with secretory thoracic lesions being exceedingly rare as only 3 previous cases have been cited.
  
  
  METHODS
  A 49-year-old woman presented with episodes of hypertension, palpitations, and diaphoresis. Workup revealed positive urine catecholamines and a thoracic spine mass extending into the thoracic apex. Preoperative α-blockade with phenoxybenzamine was used followed by posterior decompression and tumor resection. Arthrodesis from C5 to T4 was subsequently performed, and the patient received postoperative radiation.
  
  
  CONCLUSIONS
  Two years postoperatively, the patient has continued to have regression of her symptoms. We report a rare case of a catecholamine-secreting primary thoracic paraganglioma in a 49-year-old woman. These tumors should be treated carefully by the neurosurgeon with preoperative assistance from endocrinology for α-blockade, followed by gross total resection and postoperative radiation if residual tumor remains.
authors.affiliation: Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Simpson
authors.forename: Betsy D
authors.initials: BD
authors.lastname: Hughes
authors.forename: Isaac O
authors.initials: IO
authors.lastname: Karikari
authors.forename: Ankit I
authors.initials: AI
authors.lastname: Mehta
authors.forename: Tiffany R
authors.initials: TR
authors.lastname: Hodges
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Cummings
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Bagley
mesh_terms: D002395:Catecholamines / Q000378:metabolism*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008875:Middle Aged; D010236:Paraganglioma, Extra-Adrenal / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D013904:Thoracic Vertebrae
chemical_list: D002395:Catecholamines