Thoracic extradural paragangliomas: a case report and review of the literature.

Abstract STUDY DESIGN: Case report. OBJECTIVES: To report on a case of paraganglioma presenting in an uncommon extradural thoracic localization. SETTING: Department of Neurosurgery, Florence, Italy. CASE REPORT: A 43-year-old woman with a thoracic lesion extending into the extradural space along four levels, T(1)-T(4), presented with sudden spastic incomplete paraplegia and paresthesia at the lower limbs. RESULTS: The neoplasm was surgically resected 'en bloc' and histological findings corresponded to paraganglioma. One year after surgery, the patient was walking without assistance, a T(3)-T(4) hypoesthesia was still present and an magnetic resonance imaging (MRI) study showed no signs of focal recurrence. CONCLUSIONS: The imaging features of thoracic paragangliomas may be misleading and an advanced malignant lesion could be primarily suspected; thus, a histological study is always needed. Total resection is the gold standard therapy. Owing to the risk of recurrence or multicentric growth, follow-up must be prolonged and accurate.