Lumbosacral Intraspinal Paraganglioma: Clinicopathologic and Computed Tomography/Magnetic Resonance Imaging Features of 13 Cases.

Abstract

To retrospectively review the clinicopathologic features and computed tomography (CT) and magnetic resonance imaging (MRI) findings of lumbosacral intraspinal paragangliomas (PGLs). Thirteen patients with surgically and pathologically confirmed lumbosacral intraspinal PGLs were enrolled. Their clinicopathologic data and imaging findings were retrospectively reviewed. Ten male and 3 female patients with a median age of 43 years (range, 36-74 years) were included. CT or MRI showed a well-defined (n = 13), oval (n = 10), or striated (n = 3) mass with heterogeneous (n = 6) or homogeneous density/signal intensity (n = 7). The lesions appeared isointense (n = 13) and mildly hyperintense (n = 13) on T1-weighted and T2-weighted MRI, respectively. On enhanced CT/MRI, markedly heterogeneous (n = 6) and homogeneous (n = 7) enhancement patterns were observed. The tadpole sign was observed in 9 cases. Systolic and diastolic blood pressure were higher before than after surgery (P_SBP = 0.002 and P_DBP = 0.001). Both systolic and diastolic blood pressure were reduced to normal after surgery. No recurrence or metastatic disease was found during the follow-up period. Lumbosacral intraspinal PGLs should be considered when a mass appears as well defined or oval, and when a striated solitary homogeneous or heterogeneous mass is characterized by a tadpolelike appearance with a marked enhancement pattern. The fluctuation of blood pressure before and after surgery is an interesting clinical feature of lumbosacral intraspinal PGLs.