Therapy of Spinal Paragangliomas – Case Reports


Authors: L. Hrabálek 1;  O. Kalita 1;  M. Adamus 2;  J. Macháč 1;  M. Zlevorová 3;  T. Wanek 1
Authors‘ workplace: LF UP a FN Olomouc Neurochirurgická klinika 1;  LF UP a FN Olomouc Klinika anesteziologie a resuscitace 2;  LF UP a FN Olomouc Onkologická klinika 3
Published in: Cesk Slov Neurol N 2012; 75/108(5): 626-629
Category: Case Report

Overview

Spinal paragangliomas are uncommon tumors. Vast majority of these tumours present as spinal intradural extramedular tumours in the filum terminale/cauda equina region, less frequently extradurally. Authors present case reports of two male patients with tumours of the lumbar spine. Typically intradurally (L1–L2) located tumour in the first, 28 years old patient, was completely surgically removed. The second, 68 years old patient, had an advanced paraganglioma located atypically extradurally and retroperitoneally at the level of L4. The tumour was partially resected using a combined approach and vertebral body was replaced. Radiotherapy followed. In both cases, local recurrence or metastases have not been found so far and neurological status improved. Surgical resection of advanced spinal paragangliomas is difficult, since the tumour is highly vascularized. The combination of surgery with postoperative radiotherapy is an ideal curative modality for incompletely removed or recurrent tumours. Chemotherapy and treatment with 131I-metaiodobenzylguanidine seem to be less effective and are used for malignant metastatic lesions.

Key words:
paragangliomas – lumbar spine – spinal surgery – radiotherapy


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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