Secretory Paravertebral Paraganglioma of the Lumbar Spine: A Case Report and Review of Literature.

Introduction: Paragangliomas are relatively rare group of well-vascularized tumor having an origin from the embryonic neural crest cells. They arise from extra-adrenal autonomic paraganglia and have neuroendocrine cells that can secrete catecholamines. Most head and neck paragangliomas are parasympathetic type and are non-functional. They are located near the skull base and along the vagus nerve. Paragangliomas of the thoracoabdominal regions are sympathetic type and known to secrete catecholamines. It is an important cause for episodic hypertension. Triad of episodic hypertension, sweating, and palpitations is included in the classical triad for the catecholamine secreting tumors. Rarely, the paraganglioma can show features of malignancy in 10-15% of cases.

Case Report: We present here a 34-year-old female who came to us with back pain, episodic hypertension associated with palpitations, and sweating. Back pain was not associated with other neurological symptoms and neuroclaudication. She was treated with en bloc resection of the tumor with L1 corpectomy posterior instrumentation and anterior reconstruction.

Conclusion: Secretory paravertebral paraganglioma of the lumbar spine is infrequently reported. Its management requires multidisciplinary approach with optimization of perioperative blood pressure and meticulous handling of the tumor mass. In cases, where the vertebral body is destroyed, it requires anterior column reconstruction for stabilization.