MR Findings of the Spinal Paraganglioma: Report of Three Cases

Abstract

Extraadrenal paragangliomas involving the spine is less common and usually takes the form of intradural compression of the cauda equina. The authors report three cases of spinal paragangliomas resulting in extradural spinal cord compression and their MR findings. The MR imaging revealed a well-demarcated extradural mass with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-weighted images compared to paravertebral muscles. After Gd-DTPA administration, heterogeneous and intense enhancement was found. Multiple punctate and serpiginous structures of signal void due to high-velocity flow were noted around and within the tumors on all sequences. In one case, the signal void structures were well corresponded with feeding arteries on angiography. These may be the characteristic findings of the extraadrenal paraganglioma involving the spine.

Outcome of embolised vascular metastatic renal cell tumours causing spinal cord compression

“…Preoperative embolisation reduces tumour vascularity, allowing more complete resection and a lower morbidity rate in patients with hypervascular tumours. The authors of previous reports have shown efficacy for renal and non-renal spinal metastases such as melanoma, sarcoma, thyroid, breast, prostate, hepatic carcinoma, and neuroendocrine tumours such as paragangliomas [6][7][8][9][10][11][12][13]. Nevertheless, the amount of blood loss is variable [13,[17][18][19][20].…”

“…an estimate of the extent of tumour blush visible after treatment. The grading scale used in this study was similar to that used by others, including the very experienced unit in Memorial SloanKettering, New York [7,13].…”

“…Pre-operative embolisation of such hypervascular tumours aims to reduce intra-operative blood loss and improves the surgeon's ability to decompress the spinal cord and maximize tumour resection [4][5][6][7][8][9][10][11][12]. Other potential benefits include reducing mass effect, arresting tumour growth, alleviating pain, and shortening hospital stays [3,13].…”

Thoracic extradural paragangliomas: a case report and review of the literature

“…12,13 Areas of osteolysis or even pathological fractures and/or enlargement of the vertebral foraminae are often observed. 1,13,15 Osteocondensant forms have rarely been described and may also be found in the adjacent costs. 12 On MRI, paragangliomas appear hypo-iso-intense on T 1 and iso-hyper-intense, often with a 'salt & pepper' appearance on T 2 -weighted images.…”

“…[1][2][3][4][5][6] Findings in the extradural space at a cervical or dorsal spinal level are particularly rare. 1,3,4,[7][8][9][10][11][12][13][14][15] We describe the case of a thoracic extradural paraganglioma invading the thoracic cavity. A revision of the literature is reported.…”