Jeffs Graham Joseph, Lee Gabriel Yin Foo, Wong George Tse-Hwai
Department of Neurosurgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Neurosurgery. 2003 Oct;53(4):992-4; discussion 994-5. doi: 10.1227/01.neu.0000084082.08940.7f.
Paragangliomas of the thoracic spine are rare. Previously described cases involved nonfunctioning tumors. This report documents the diagnosis and surgical treatment for a patient who presented with a functioning thoracic paraganglioma.
A 53-year-old woman presented with a 10-month history of headaches, facial flushing, and palpitations associated with hypertension. Urinary catecholamine levels were markedly elevated. Magnetic resonance imaging and m-[(123)I]iodobenzylguanidine scans demonstrated an extradural tumor located within the T12 vertebra, with a significant paraspinal component. The neurological examination revealed mild hypesthesia in the right T12 dermatome.
The patient underwent resection of the tumor after alpha-adrenergic receptor blockade. Grossly complete excision was achieved without neurological complications. Postoperatively, the patient was normotensive and exhibited catecholamine levels within the normal range.
Functioning paragangliomas of the thoracic spine are rare lesions that are difficult to treat. Successful treatment requires careful surgical planning and expert pharmacological manipulation.
胸椎副神经节瘤罕见。既往报道的病例均为无功能肿瘤。本报告记录了一例有功能的胸椎副神经节瘤患者的诊断及手术治疗情况。
一名53岁女性，有10个月的头痛、面部潮红及心悸病史，伴有高血压。尿儿茶酚胺水平显著升高。磁共振成像及间碘苄胍扫描显示T12椎体硬膜外肿瘤，伴有明显的椎旁成分。神经系统检查发现右侧T12皮节轻度感觉减退。
患者在α-肾上腺素能受体阻滞治疗后接受肿瘤切除术。实现了大体完整切除，无神经并发症。术后，患者血压正常，儿茶酚胺水平在正常范围内。
有功能的胸椎副神经节瘤是罕见且难以治疗的病变。成功治疗需要精心的手术规划和专业的药物处理。
