Paraganglioma of the Cauda Equina Region: A Case Report

Paraganglioma is a rare neuroendocrine tumor that is assumed to be derived from paraganglia. This report describes the clinical presentation and treatment outcome of a paraganglioma in the cauda equina region. A 47-year-old female patient presented with 2 months of lower back pain and severe radiating pain in the extremities of both legs. Magnetic resonance imaging of the lumbosacral spine disclosed an oval-shaped lesion measuring 2.6×1.4×1.5 cm at the L3 level. T2-weighted images (WIs) revealed a high signal intensity lesion with signal void capping the tumor, and T1-WI demonstrated a slightly low signal. Gross total removal of the tumor was performed without any intraoperative hyperadrenergic signs. Pathological findings showed Zellballen appearance and immunochemistry with antisera to synaptophysin showed that the tumor was consistent with neuroendocrine lineages, indicating a chromaffin cell origin. Clinically, the patient showed improvement of lower back and radiating pain, without any neurological deficit postoperatively. This case emphasizes the importance of preoperative suspicion of paraganglioma, as surgery is the safest way to remove the lesion. Excellent results can be obtained with surgical removal in most cases of paraganglioma. Key words: Cauda equina; Lumbar vertebrae; Neoplasms; Paraganglioma