Abstract
Paragangliomas of spine are rare neuroendocrine tumors. They are World Health Organization
grade 1 tumors with common location in cauda equina and filum terminale. We report
a case of conus paraganglioma. A 57-year-old lady was admitted with low back pain
with radiculopathy without bowel and bladder complaints. Magnetic resonance imaging
(MRI) lumbosacral spine showed well-defined round-to-oval extramedullary lesion isointense
on T1 and hyperintense on T2-weighted images at the level of L1 vertebra (suggestive
of) neurogenic tumor. Intraoperatively reddish-brown capsulated tumor arising from
conus with extension to filum and compressing the nerve roots was seen. Gross total
excision of tumor was done. Microscopic examination showed well-encapsulated cellular
tumor composed of sheets, anastomosing lobules, and nests of small, oval-to-round
cells interspersed with blood vessels with mild nuclear atypia and occasional mitosis.
Immunohistochemistry analysis was positive for synaptophysin and chromogranin suggestive
of paraganglioma. Postoperative period was uneventful. MRI of dorso-lumbar spine showed
no residual tumor. Patient was asymptomatic 5 months after surgery. The clinical,
radiological, and pathological features of this rare tumor entity is presented.
Keywords
paraganglioma - spine
