Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 May 24;14(8):926-929.
doi: 10.1016/j.radcr.2019.05.004. eCollection 2019 Aug.

Transcatheter arterial embolization for relapsed spinal metastatic paraganglioma: A case report

Wataru Makino  1 , Joichi Heianna  1 , Masafumi Toguchi  1 , Taiki Teruya  2 , Sadayuki Murayama  1
Affiliations
Case Reports

Transcatheter arterial embolization for relapsed spinal metastatic paraganglioma: A case report

Wataru Makino et al. Radiol Case Rep. .

Abstract

Spinal metastasis is a rare presentation of paraganglioma and an effective therapy for nonresectable spinal metastatic paraganglioma (MPG) has not yet been established. We report the case of a 42-year-old woman with metastatic spinal cord compression caused by a relapsed spinal MPG after decompressive surgery. We performed transcatheter arterial embolization (TAE) in addition to systemic chemotherapy. After TAE, the neurologic symptoms improved, and the back pain was reduced. After 3 sessions of TAE, MRI revealed that the tumor at the level of the seventh thoracic vertebra had shrunk and the pressure on spinal cord had decreased. TAE might be a feasible treatment option for spinal MPG, even after surgery or irradiation.

Keywords: Metastatic paraganglioma; Spinal cord compression; Spinal metastasis; Transcatheter arterial embolization.

PubMed Disclaimer

Figures

Fig 1
Fig. 1
(A) Radiograph in anteroposterior view after arthrodesis of T5-T9. (B) Radiograph in lateral view after arthrodesis of T5-T9.
Fig 2
Fig. 2
Pathohistology of the spinal metastasis (hematoxylin–eosin staining, × 200). The tumor is composed of heteromorphic cells with small and large circular nuclei with prominent nucleoli. The nests of tumor cells are separated by vascular septa. This is a so called Zellballen structure, which is characteristic of paraganglioma.
Fig 3
Fig. 3
(A) Angiogram of the right sixth intercostal artery demonstrates the tumor blush that corresponds to the spinal metastasis (arrow). (B) After TAE, the tumor blush disappears.
Fig 4
Fig. 4
T2-weighted MRI before TAE (A-B). T2-weighted MRI after three sessions of TAE (C-D). (A) A tumor in the right Th7 pedicle strongly compresses the dural sac from the right side (arrow). (B) A tumor (3.3 cm × 2.1 cm) on the right side of the Th5 vertebral body (arrow head). (C) The tumor in the Th7 right pedicle shrinks and compression of the dural sac is reduced. (D) The size of the tumor on the right side of Th5 vertebral body, for which we did not perform TAE, increases slightly (3.4 cm × 2.3 cm) compared with B.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Simpson L.N., Hughes B.D., Karikari I.O., Mehta A.I., Hodges T.R., Cummings T.J. Catecholamine-secreting paraganglioma of the thoracic spinal column: report of an unusual case and review of the literature. Neurosurgery. 2012;70(4):E1049–E1052. (discussion E52) - PubMed
    2. Simpson L.N., Hughes B.D., Karikari I.O., et al.AU: Please note that as per the journal style, if there are more than six authors, the first six author names are listed followed by ‘et al.’ Therefore, in Ref(s). 1,4,5,8,9,10.Please provide the names of all authors if the author group consists of six authors or fewer (2012) Catecholamine-secreting paraganglioma of the thoracic spinal column: report of an unusual case and review of the literature. Neurosurgery70(4): E1049–E1052(discussion E52) - PubMed
    1. Lehmen J.A., Babbel D.M., Mikhitarian K., Choma T.J. Paraganglioma presenting as metastatic lesion in a cervical vertebra: a case report and review of the literature. Spine. 2010;35(5):E152–E154. - PubMed
    2. Lehmen J.A., Babbel D.M., Mikhitarian K., Choma T.J. (2010) Paraganglioma presenting as metastatic lesion in a cervical vertebra: a case report and review of the literature. Spine35(5): E152–E154 - PubMed
    1. Lau D., La Marca F., Camelo-Piragua S., Park P. Metastatic paraganglioma of the spine: case report and review of the literature. Clin Neurol Neurosurg. 2013;115(9):1571–1574. - PubMed
    2. Lau D., La Marca F., Camelo-Piragua S., Park P. (2013) Metastatic paraganglioma of the spine: case report and review of the literature. Clin Neurol Neurosurg115(9):1571–1574 - PubMed
    1. Jia Q., Yin H., Yang J., Wu Z., Yan W., Zhou W. Treatment and outcome of metastatic paraganglioma of the spine. Eur Spine J. 2017 - PubMed
    2. Jia Q., Yin H., Yang J., et al. (2017) Treatment and outcome of metastatic paraganglioma of the spine. Eur Spine J. doi:10.1007/s00586-017-5140-5 - PubMed
    1. Yin M., Huan Q., Sun Z., He S., Xia Y., Mo W. Clinical characteristics and surgical treatment of spinal paraganglioma: a case series of 18 patients. Clin Neurol Neurosurg. 2017;158:20–26. - PubMed
    2. Yin M., Huan Q., Sun Z., et al. (2017) Clinical characteristics and surgical treatment of spinal paraganglioma: a case series of 18 patients. Clin Neurol Neurosurg158:20–26 - PubMed

Publication types

LinkOut - more resources