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Trans-arterial Onyx Embolization of a Functional Thoracic Paraganglioma.

Chacón-Quesada T, Rodriguez GJ, Maud A, Ramos-Duran L, Torabi A, Fitzgerald T, Akle N, Cruz Flores S, Trier T - Neurointervention (2015)

Bottom Line: They are highly vascular and in some cases hormonally active, making their management challenging.Although there is strong evidence of the safety and effectiveness of preoperative embolization in the management of spinal tumors, only five cases have been reported in the setting of thoracic paragangliomas.We present the case of a 19-year-old man with a large, primary, functional, malignant paraganglioma of the thoracic spine causing a vertebral fracture and spinal cord compression.

View Article: PubMed Central - PubMed

Affiliation: Center of Excellence in Neurosciences, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, EL Paso, TX, USA.

ABSTRACT
Paragangliomas are rare tumors of the endocrine system. They are highly vascular and in some cases hormonally active, making their management challenging. Although there is strong evidence of the safety and effectiveness of preoperative embolization in the management of spinal tumors, only five cases have been reported in the setting of thoracic paragangliomas. We present the case of a 19-year-old man with a large, primary, functional, malignant paraganglioma of the thoracic spine causing a vertebral fracture and spinal cord compression. To our knowledge this is the first report of preoperative trans-arterial balloon augmented Onyx embolization of a thoracic paraganglioma.

No MeSH data available.


Related in: MedlinePlus

Digital Subtraction Angiography. A. Diagnostic angiogram in the anterior-posterior view shows a highly vascular tumor. Note the prominent tumor blush within the main feeders (T7-T9). B. Control angiogram after each ONYX embolization reveals complete devascularization with no residual tumor blush.
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Figure 2: Digital Subtraction Angiography. A. Diagnostic angiogram in the anterior-posterior view shows a highly vascular tumor. Note the prominent tumor blush within the main feeders (T7-T9). B. Control angiogram after each ONYX embolization reveals complete devascularization with no residual tumor blush.

Mentions: A 19-year-old man with 6-year history of chest pain and 6 months of progressive paraplegia with associated hypertension was admitted for further work up of a known mass in the thoracic spine. MRI findings evidenced a thoracic tumor extending from T4 to T9 with an associated T6 vertebral fracture and a L3 metastatic lesion (Fig. 1A and 1B). Iodine-123 metaiodobenzylguanidine scintigraphy (I-123 MIBG) showed intense uptake within the same areas (Fig. 1C). A spinal digital subtraction angiography (DSA) showed a prominent tumor blush, with arterial feeders arising from the right T5 through T10 intercostal arteries. The most prominent arterial feeders were T7 through T9 (Fig. 2A).


Trans-arterial Onyx Embolization of a Functional Thoracic Paraganglioma.

Chacón-Quesada T, Rodriguez GJ, Maud A, Ramos-Duran L, Torabi A, Fitzgerald T, Akle N, Cruz Flores S, Trier T - Neurointervention (2015)

Digital Subtraction Angiography. A. Diagnostic angiogram in the anterior-posterior view shows a highly vascular tumor. Note the prominent tumor blush within the main feeders (T7-T9). B. Control angiogram after each ONYX embolization reveals complete devascularization with no residual tumor blush.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4355644&req=5

Figure 2: Digital Subtraction Angiography. A. Diagnostic angiogram in the anterior-posterior view shows a highly vascular tumor. Note the prominent tumor blush within the main feeders (T7-T9). B. Control angiogram after each ONYX embolization reveals complete devascularization with no residual tumor blush.
Mentions: A 19-year-old man with 6-year history of chest pain and 6 months of progressive paraplegia with associated hypertension was admitted for further work up of a known mass in the thoracic spine. MRI findings evidenced a thoracic tumor extending from T4 to T9 with an associated T6 vertebral fracture and a L3 metastatic lesion (Fig. 1A and 1B). Iodine-123 metaiodobenzylguanidine scintigraphy (I-123 MIBG) showed intense uptake within the same areas (Fig. 1C). A spinal digital subtraction angiography (DSA) showed a prominent tumor blush, with arterial feeders arising from the right T5 through T10 intercostal arteries. The most prominent arterial feeders were T7 through T9 (Fig. 2A).

Bottom Line: They are highly vascular and in some cases hormonally active, making their management challenging.Although there is strong evidence of the safety and effectiveness of preoperative embolization in the management of spinal tumors, only five cases have been reported in the setting of thoracic paragangliomas.We present the case of a 19-year-old man with a large, primary, functional, malignant paraganglioma of the thoracic spine causing a vertebral fracture and spinal cord compression.

View Article: PubMed Central - PubMed

Affiliation: Center of Excellence in Neurosciences, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, EL Paso, TX, USA.

ABSTRACT
Paragangliomas are rare tumors of the endocrine system. They are highly vascular and in some cases hormonally active, making their management challenging. Although there is strong evidence of the safety and effectiveness of preoperative embolization in the management of spinal tumors, only five cases have been reported in the setting of thoracic paragangliomas. We present the case of a 19-year-old man with a large, primary, functional, malignant paraganglioma of the thoracic spine causing a vertebral fracture and spinal cord compression. To our knowledge this is the first report of preoperative trans-arterial balloon augmented Onyx embolization of a thoracic paraganglioma.

No MeSH data available.


Related in: MedlinePlus