Paolo Palmisciano1, Navraj S Sagoo2, Ali S Haider3, Christian Ogasawara4, Maya Ogasawara5, Othman Bin Alamer6, Keemia S Heidari2, Karuna M Raj7, Gianluca Scalia8, Giuseppe E Umana9, Ajit A Krishnaney10, Salah G Aoun11, Peter G Passias12, Shaleen Vira2. 1. Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy. Electronic address: paolo.palmisciano94@gmail.com. 2. Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 3. Texas A&M University College of Medicine, Houston, Texas, USA. 4. John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawai'i, USA. 5. University of California, Berkeley, California, USA. 6. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 7. Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 8. Department of Neurosurgery, Highly Specialized Hospital of National Importance "Garibaldi" Catania, Italy. 9. Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy. 10. Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA. 11. Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. 12. Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, New York, USA.
Abstract
BACKGROUND: Primary spine paragangliomas are rare tumors. Surgical resection plays a role, but aggressive lesions are challenging. We reviewed the literature on primary spine paragangliomas. METHODS: PubMed, Scopus, Web of Science, and Cochrane were searched following the PRISMA guidelines to include studies on primary spine paragangliomas. Clinical-radiologic features, treatments, and outcomes were analyzed and compared between cauda equina versus non-cauda equina tumors. RESULTS: We included 143 studies comprising 334 patients. Median age was 46 years (range, 6-85 years). The most frequent symptoms were lower back (64.1%) and radicular (53.9%) pain, and sympathetic in 18 patients (5.4%). Cauda equina paragangliomas (84.1%) had frequently lumbar (49.1%) or lumbosacral (29%) locations. Non-cauda equina tumors were mostly in the thoracic (11.4%), thoracolumbar (5.1%), and cervical (3.6%) spine. Median tumor diameter was 2.5 cm (range, 0.5-13.0 cm). Surgical resection (98.5%) was preferred over biopsy (1.5%). Decompressive laminectomy (53%) and spine fusion (6.9%) were also performed. Adjuvant radiotherapy was delivered in 39 patients (11.7%) with aggressive tumors. Posttreatment symptomatic improvement was described in 86.2% cases. Median follow-up was 19.5 months (range, 0.1-468.0 months), and 23 patients (3.9%) had tumor recurrences. No significant differences were found between cauda equina versus non-cauda equina tumors. CONCLUSIONS: Surgical resection is effective and safe in treating primary spine paragangliomas; however, adjuvant treatments may be needed for aggressive lesions.
BACKGROUND: Primary spine paragangliomas are rare tumors. Surgical resection plays a role, but aggressive lesions are challenging. We reviewed the literature on primary spine paragangliomas. METHODS: PubMed, Scopus, Web of Science, and Cochrane were searched following the PRISMA guidelines to include studies on primary spine paragangliomas. Clinical-radiologic features, treatments, and outcomes were analyzed and compared between cauda equina versus non-cauda equina tumors. RESULTS: We included 143 studies comprising 334 patients. Median age was 46 years (range, 6-85 years). The most frequent symptoms were lower back (64.1%) and radicular (53.9%) pain, and sympathetic in 18 patients (5.4%). Cauda equina paragangliomas (84.1%) had frequently lumbar (49.1%) or lumbosacral (29%) locations. Non-cauda equina tumors were mostly in the thoracic (11.4%), thoracolumbar (5.1%), and cervical (3.6%) spine. Median tumor diameter was 2.5 cm (range, 0.5-13.0 cm). Surgical resection (98.5%) was preferred over biopsy (1.5%). Decompressive laminectomy (53%) and spine fusion (6.9%) were also performed. Adjuvant radiotherapy was delivered in 39 patients (11.7%) with aggressive tumors. Posttreatment symptomatic improvement was described in 86.2% cases. Median follow-up was 19.5 months (range, 0.1-468.0 months), and 23 patients (3.9%) had tumor recurrences. No significant differences were found between cauda equina versus non-cauda equina tumors. CONCLUSIONS: Surgical resection is effective and safe in treating primary spine paragangliomas; however, adjuvant treatments may be needed for aggressive lesions.
Authors: Mohammed Maan Al-Salihi; Muath Hussein; Maryam Sabah Al-Jebur; Sabrina Rahman; Ali Ayyad; Md Moshiur Rahman Journal: Int J Surg Case Rep Date: 2022-09-24