Giant Paraganglioma of the Cauda Equina in Adolescence: Magnetic Resonance Imaging Demonstration

Abstract

A case of giant paraganglioma of the cauda equina is presented. This is only the second reported case in a minor and the first with magnetic resonance imaging . At 13 em long, this is the largest paraganglioma of the cauda equina ever recorded .

Paragangliomas of the lumbar region

“…2,51 After Gd injection, remarkable homogeneous enhancement was observed in 13 cases, 1,6,10,13,18,25,47,48,52,67,88,92 heterogeneous in eight, 2,3,14,25,26,68,79,90,93 and in the remaining eight the enhancement was minimal. 3,34,51,62,79,101,103 There was only one intramedullary cyst 26 and one syrinx. 88 Treatment.…”

“…Revealing Symptoms. Initial symptoms were low-back pain in 89 cases (51.4%), 1-3,9-13,16,17,20,21,23,25-28,30,34,35,37,40,41,46-48, 50,51,53,58,60-63,69,71-73,75-78,81-83,85,87-89,91,92,94,95,97,99,104 low-back pain and sciatica in 33 (19%), 8,11,14,16,38,54,73,87,90,93,96 unilateral sciatica in 12 and bilateral sciatica in three, 4,5,12,15,27,33,42,52,60,68,71,72,74,92,101 clinical symptoms of intracranial hypertension in six, 7,31,32,67,79,98 progressive or sudden weakness in six, 6,24,73,77,87,103 alterations in sensation in three, 60,87,93 sexual dysfunction in two, 43,73 and lumboischialgia, 86 urinary retention, 18 pseudoclaudication, 87 signs of spinal cord compression, 60 sacral...…”

“…All tumors were located in the lumbosacral region, and six extended toward the thoracic region. 12,67,68,87,93,103 In 31 cases, the tumor appeared in the terminal filum, 38,60,77,87 23 in the lumbar region, 29,30,60,69 10 in the cauda equina, 11,46,55,60,87 four in the conus medullaris, 26,54,61,69,87 and its localization was not specified in the remaining five cases. 15,45,66 All cases except one in the series reported by Sundgren and colleagues 92 were intradurally located.…”

“…82 Immunohistochemical Assay. Immunohistochemical evaluation was performed in 116 cases: S100 protein was present in 75 cases 13,17,20,22,23,28,35,45,60,68,73,76,83,87,88,91,101,103,104 and absent in five cases; 2,8,25,60,93 NSE was demonstrated in all 64 cases tested; 2,3,8,13,[17][18][19]21,22,28,52,60,61,67,68,72,76,79,83,87,88,[91][92][93]95,100,101...…”

Acute Paraplegia From Hemorrhagic Paraganglioma Of Filum Terminale: Case Report And Review Of Literature

“…17,28 Sensory or motor deficits, sphincteric and erectile dysfunction and paraplegia may also occur, but their incidence is relatively low. 3,12,17,19,24,33,34,43,49 We present a case of a 51-year old male with hemorrhagic paraganglioma of the filum terminale. He presented with acute paraplegia and was treated via emergent laminectomy, evacuation of hematoma, and resection of tumor.…”