World Journal of Endocrine Surgery

Register      Login

VOLUME 13 , ISSUE 3 ( September-December, 2021 ) > List of Articles

CASE REPORT

A Child with Paraspinal Paraganglioma: A Rare Case Presentation

Upander Kumar, Nancy Raja, Ganesh Bhat, Rizhin Sooraj, Poorvi Mathur, Kul R Singh, Chanchal Rana, Pooja Ramakant, Anand Mishra

Keywords : Blood pressure, Normetanephrine, Paragangliomas, Paraspinal, Pheochromocytoma

Citation Information : Kumar U, Raja N, Bhat G, Sooraj R, Mathur P, Singh KR, Rana C, Ramakant P, Mishra A. A Child with Paraspinal Paraganglioma: A Rare Case Presentation. World J Endoc Surg 2021; 13 (3):102-105.

DOI: 10.5005/jp-journals-10002-1414

License: CC BY-NC 4.0

Published Online: 19-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim: To manage a rare case of paraspinal paraganglioma in an 8-year-old female. Background: Functional paraspinal paragangliomas are exceptionally rare entities in both adult and pediatric age groups. These tumors are closely associated with major vascular structures like the aorta and are in close proximity to the spinal nerves and threatened with deadly vascular complications (e.g., hemorrhagic shock) and neurological complications (e.g., paralysis or paresis of the lower limb). So managing pediatric patients with safe outcomes is a challenge. Case description: An 8-year-old female child presented with a two years history of headache, palpitations, sweating, and high blood pressure with no neurological deficit. On evaluation, she was found to have elevated urinary normetanephrine levels and a left lateral paraspinal mass located at the level of T7–T11 vertebral bodies on imaging. She was managed with preoperative alpha-adrenergic blockade followed by complete tumor resection. Conclusion: Biochemical evaluation, perioperative care with adequate α-blockade, and timely follow-up is necessary for best outcomes in functional paraspinal paraganglioma. Clinical significance: High suspicion of an index and multidisciplinary teamwork were key in diagnosing and managing this rare tumor.


PDF Share
  1. Akhtar S, Sattar S, Bari E, et al. Secretory paraspinal paraganglioma of thoracolumar spine: case report and review of literature. Surg Neurol Int 2016;7(37):S889–S892. DOI: 10.4103/2152-7806.194510
  2. Whalen RK, Althausen AF, Daniels GH. Extra-adrenal pheochromocytoma. J Urol 1992;147(1):1–10. DOI: 10.1016/s0022-5347(17)37119-7
  3. Linet MS, Ries LA, Smith MA, et al. Cancer surveillance series: recent trends in childhood cancer incidence and mortality in the United States. J Natl Cancer Inst 1999;91(12):1051–1058. DOI: 10.1093/jnci/91.12.1051
  4. Fonkalsrud EW. Pheochromocytoma in childhood. Prog Pediatr Surg 1991;26:103–11. DOI:10.1007/978-3-642-88324-8_13
  5. Pamporaki C, Hamplova B, Peitzsch M, et al. Characteristics of pediatric vs adult pheochromocytomas and paragangliomas. J Clin Endocrinol Metab 2017;102(4):1122–1132. DOI: 10.1210/jc.2016-3829
  6. Jeffs GJ, Lee GYF, Wong GT-H. Functioning paraganglioma of the thoracic spine: case report. Neurosurgery 2003;53(4):992–994. DOI: 10.1227/01.neu.0000084082.08940.7f
  7. Pham TH, Moir C, Thompson GB, et al. Pheochromocytoma and paraganglioma in children: a review of medical and surgical management at a tertiary care center. Pediatrics 2006;118(3):1109–1117. DOI: 10.1542/peds.2005-2299
  8. Bholah R, Bunchman TE. Review of pediatric pheochromocytoma and paraganglioma. Front Pediatr 2017;5:155. DOI: 10.3389/fped.2017.00155
  9. Gardet V, Gatta B, Simonnet G, et al. Lessons from an unpleasant surprise: a biochemical strategy for the diagnosis of pheochromocytoma. J Hypertens 2001;19(6):1029–1035. DOI: 10.1097/00004872-200106000-00006
  10. Lenders JWM, Duh Q-Y, Eisenhofer G, et al. Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014;99(6):1915–42. DOI: 10.1210/jc.2014-1498
  11. Yuan M, Xu C, Yang G, et al. Pediatric paraganglioma of the posterior mediastinum: a case report and review of literature. Medicine (Baltimore) 2018;97(27):e11212. DOI: 10.1097/MD.0000000000011212
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.