Functioning paraganglioma of the cervical spine.

Full article available online at ORTHOSuperSite.com. Search: 20110826-27 Extradural paraganglioma of the cervical spine is rarely seen. Few reports of this functioning disorder appear in the literature. A 29-year-old woman presented with a 1-year history of left shoulder pain and occasional transitional dizziness. This is the fi rst case of a functioning cervical spinal paraganglioma with symptoms of catecholamine excess throughout the operation. A mass in the neck region was discovered by the patient 2 months prior to hospital admission. Physical examination revealed an egg-shaped soft and unfl exible mass with no clear boundary in the anterior left part of the neck. Neither sensory disturbance nor motor weakness was evident in the upper and lower extremities. Laboratory studies were normal. Both computed tomography and magnetic resonance imaging implied neurilemmoma. Embolization of the branches supplying the mass was taken to reduce perioperative bleeding complications 1 day preoperatively. The patient demonstrated frequent hypertensive spikes with tumor handling. The blood pressure changed between 80/40 mm Hg and 200/105 mm Hg throughout the surgery. The tumor was dissected successfully from the paraspinal tissues, followed by spinal cord decompression of C4 to C6, C5 corpectomy, anterior column reconstruction, and anterior internal fi xation with a plate. The histopathological examination yielded a postoperative diagnosis of paraganglioma. Diagnosis and treatment of this rare case require comprehensive perioperative management and meticulous surgical excision. Drs Chen, Luo, Liu, and Yang are from the Department of Orthopedics, First Affi liated Hospital of Soochow University, Suzhou, Jiangsu Province, China. Drs Chen, Luo, Lin, and Yang have no relevant fi nancial relationships to disclose. Correspondence should be addressed to: Huilin Yang, Department of Orthopedics, First Affi liated Hospital of Soochow University, 188 Shizi St, Suzhou, Jiangsu Province 215006, China (huiliny@126. com). doi: 10.3928/01477447-20110826-27 Functioning Paraganglioma of the Cervical Spine GUANGDONG CHEN, MD; ZONGPING LUO, MD, PHD; TAO LIU, MD; HUILIN YANG, MD, PHD e700 Figure: CT images showing an epidural soft tissue mass located between the trachea and cervical spine including C2 to C7. The big paravertebral tumor was connected with the little intracanal tumor on the left side. The left transverse process and foramen of C4, C5, and C6 were destroyed by the tumor. The tumor extended into the spinal canal and compressed the spinal cord (A, B). A