Paraganglioma of the Spine: Review of Six Cases in 20 Years at a Single Institution

Paragangliomas are rare neuroendocrine tumors that may localize to the spine causing progressive low back pain variably accompanied by radiculopathy. Recurrence, follow-up duration, and role of adjuvant therapy remain unestablished. We interrogated our institution’s histopathology database for all confirmed cases of spinal paraganglioma between 2000 and 2021. Patient records were retrospectively reviewed to extract diagnostic features, operative treatment, and follow-up outcomes. Six cases of spinal paraganglioma were surgically treated (67% female vs. 33% male, mean age 51.3 years). Preoperative symptom duration did not correlate with tumor size (Spearman r = 0.154, p = 0.80). Mean postoperative follow-up duration lasted 3.3 years (range, 2-96 months). There was an equal number of primary and metastatic lesions. One tumor exhibited secretory features and was consequently embolized preoperatively. No residual or recurrent disease was evident in the primary cases, however two metastatic cases recurred within two years of surgery and one patient died. Given nonspecific clinical and radiologic features, spinal paragangliomas are diagnosed via biopsy or after surgery. Complete surgical resection is often necessary to alleviate symptoms and prevent tumor recurrence. In cases with benign metastases, long-term surveillance is important and adjuvant medical and radiotherapeutic treatment may be beneficial.