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Extradural paraganglioma with multiple skeletal metastases

Rajesh Jindel, MD A. K. Gupta, MD A. K. Mahapatra, MS, MCh ^* C. S. Bal, MD and R. M. Singhal, MD

Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India ^* Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

This excerpt was created in the absence of an abstract.

Tumours arising from the paraganglia (paragangliomas) are characteristically of low malignant potential, with only 10% developing distant metastases (North et al, 1990). Malignancy in paragangliomas is defined either by local invasion or spread to distant sites normally devoid of paraganglia (Irons et al, 1977; Jackson et al, 1982). We present a case with several unusual features: (1) the primary site of the tumour is in the extradural space at D7 and L3 levels (lesion at L3 not biopsied), (2) multiple skeletal metastases at a short interval after primary diagnosis, and (3) absence of mitoses both in the original specimen and the metastatic deposit.

A 29-year-old man presented in December 1989 with girdle pain in the upper abdomen for 3 months, descending numbness and paraparesis for 3 weeks and incontinence for 1 week.

Key Words: Extradural paraganglioma • Skeletal metastases • Radiotherapy • Chemotherapy

Received for publication August 6, 1991. Revision received January 2, 1992. Accepted for publication March 6, 1992.