Paragangliomas of the spine: a retrospective case series in a national reference French center

Autor: Constantin Tuleasca, Ahmed Salim Al-Risi, Philippe David, Clovis Adam, Fabrice Parker, Nozar Aghakhani
Přispěvatelé: Laboratoire de Traitement du signal [EPFL] / Signal Processing Laboratories (SP Lab), Ecole Polytechnique Fédérale de Lausanne (EPFL), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Sorbonne Université (SU), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Université de Lausanne (UNIL)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Microsurgery
medicine.medical_treatment
[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Single Center
Radiosurgery
cauda-equina region
030218 nuclear medicine & medical imaging
Paraganglioma
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Postoperative Period
Spinal Cord Neoplasms
Neuroradiology
Retrospective Studies
Radiation
medicine.diagnostic_test
business.industry
Interventional radiology
Perioperative
intramedullary surgery
Middle Aged
medicine.disease
Low back pain
Magnetic Resonance Imaging
Spine
3. Good health
Surgery
Radiography
Treatment Outcome
Female
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Neurology (clinical)
Neurosurgery
medicine.symptom
Paraplegia
business
030217 neurology & neurosurgery
Zdroj: Acta Neurochirurgica
Acta Neurochirurgica, Springer Verlag, In press, ⟨10.1007/s00701-019-04186-8⟩
ISSN: 0001-6268
0942-0940
DOI: 10.1007/s00701-019-04186-8⟩
Popis: International audience; INTRODUCTION: Primary paragangliomas (PG) of the spine are extremely rare entities. The present study reviews our experience over a period of 30 years.METHODS: This is a retrospective, single center, observational study. Patients surgically treated for a spinal PG with confirmed anatomopathological diagnosis were included. The McCormick classification was used as a reference for clinical evaluation. Follow-up MRI and clinical assessment took place at 6 weeks, 3 months, 6 months, and 1 year after surgery and on yearly basis after.RESULTS: Six cases have been operated in our institution. The mean age was 37.8 (median 35.5, 30-53). The mean follow-up period was 9.6 years (median 9.5, 1-23). Preoperative duration of symptoms varied between a few hours to 4 years. Low back pain was most common sign. One presented with hemorrhage and acute onset of paraplegia. All patients underwent single surgery, with the exception of one case, which had two surgeries on the same anatomical site and a third surgery on another location of the same tumor type. Preoperatively, McCormick scale was I in four cases, and II and IV in one case, respectively. Postoperatively, all patients in McCormick I retained the same class; one patient in McCormick II passed to McCormick III; the case in McCormick IV recovered to McCormick II. Five of eight surgeries achieved total resection, while two surgeries accomplished a partial microsurgical excision and one a gross total resection. Three patients had spinal leptomeningeal dissemination. Two of them benefited from extended spine radiotherapy, while the other of a "wait-and-scan" policy. Spinal leptomeningeal dissemination was stable in all patients at last follow-up.CONCLUSION: We consider surgery as primary treatment in all PG. In our experience, preoperative diagnosis is difficult and caution must be taken to perioperative course in these cases. We do not routinely perform postoperative radiation if there is a residual tumor. We regularly perform clinical and radiological follow-up, so as to be able to document recurrent cases, which have been reported even up to 30 years after primary surgical excision.
Databáze: OpenAIRE
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