title: Secretory paraspinal paraganglioma of thoracolumar spine: Case report and review of literature.
abstract: BACKGROUND
  Pheochromocytomas are catecholamine secreting tumors of the adrenal medulla chromaffin cells, however, when present extra-adrenally they are called paragangliomas. Paragangliomas rarely produce catecholamine in excess, which is evident by clinical symptoms, urine, and blood biochemistry. Total resection of these tumors can lead to complete clinical and biochemical resolution. This case report presents the clinical features, radiological findings, and neurological outcome in a middle-aged female with a secretory paraganglioma.
  
  
  METHODS
  We present the case of a 34-year-old female who presented with a 2-year history of dizziness, flushing, headache, palpitations, and hypertension. Her blood workup showed raised urinary catecholamine levels. Magnetic resonance imaging (MRI) and iodine-123-meta-iodobenzylguanidine (MIBG) scans demonstrated a retroperitoneal mass located anterolateral to T11-T12 vertebral bodies reaching up to T12-L1 intervertebral disc. The patient was otherwise neurologically intact. She underwent resection of the tumor after alpha-adrenergic and beta-adrenergic blockade. En bloc resection was achieved without neurological complications. Postoperatively, the patient was initially hypotensive and subsequently became normotensive, and on follow-up, the patient had resolution of her symptoms and was stable.
  
  
  CONCLUSIONS
  Secretory paraganglioma of the dorsal spine are rare and difficult to excise, needs preoperative preparation with pharmacological intervention, good operative technique, and postoperative care.
authors.affiliation: Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Saad
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Sidra
authors.initials: S
authors.lastname: Sattar
authors.affiliation: Department of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Bari
authors.affiliation: Department of Histopathology, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Naila
authors.initials: N
authors.lastname: Kayani
authors.affiliation: Department of Histopathology, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Sarosh
authors.initials: S
authors.lastname: Moeen
keywords: Paraganglioma; paraspinal; secretory; thoracolumbar spine