NYMC Faculty Publications
Leptomeningeal Dissemination of a Low-grade Lumbar Paraganglioma: Case Report
DOI
10.3171/2016.10.SPINE16948
Journal Title
Journal of Neurosurgery.Spine
First Page
501
Last Page
506
Document Type
Article
Publication Date
April 2017
Department
Neurosurgery
Disciplines
Medicine and Health Sciences
Abstract
Leptomeningeal dissemination of paraganglioma is rare, with only 2 prior cases in the literature. The authors present the case of a metastatic low-grade lumbar paraganglioma via leptomeningeal dissemination. This report emphasizes the utility of 3,4-dihydroxy-6-(18)F-fluoro-l-phenylalanine ((18)F-FDOPA) PET scanning for diagnosis, as well as the combination of radiation therapy and alkylating chemotherapeutic agents for the treatment of this rare phenomenon. The patient was a 61-year-old woman who presented with low-back pain and was found to have an isolated L-3 intrathecal tumor on MRI. Sixteen months after gross-total en bloc resection of the paraganglioma, the patient again became symptomatic with new neurological symptoms. MRI findings revealed enhancing leptomeningeal nodules throughout the spine. (18)F-FDOPA PET/CT scanning was used to confirm the diagnosis of disseminated paraganglioma. Intrathecal thiotepa, radiation therapy, and systemic therapy with capecitabine and temozolomide have been used sequentially over a 2-year period, with each able to stabilize tumor growth for several months. The authors also summarize the 2 other reports of leptomeningeal dissemination of paragangliomas in the literature and compare the course and management of the 3 cases.
Recommended Citation
Thomson, N., Pacak, K., Schmidt, M., Palmer, C., Salzman, K., Champine, M., Schiffman, J., & Cohen, A. (2017). Leptomeningeal Dissemination of a Low-grade Lumbar Paraganglioma: Case Report. Journal of Neurosurgery.Spine, 26 (4), 501-506. https://doi.org/10.3171/2016.10.SPINE16948
