• Lauren N Simpson, Betsy D Hughes, Isaac O Karikari, Ankit I Mehta, Tiffany R Hodges, Thomas J Cummings, and Carlos A Bagley.
• Division of Neurosurgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
• Neurosurgery. 2012 Apr 1;70(4):E1049-52; discussion E1052.

Background And ImportanceParagangliomas 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.Clinical PresentationA 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.ConclusionTwo 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.

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