A Child with Paraspinal Paraganglioma: A Rare Case Presentation

G. Bhat, Kulranjan Singh, C. Rana, Anshuman Mishra, P. Ramakant, Upander Kumar, N. Raja, Rizhin Sooraj, Poorvi Mathur
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Abstract

Aim: To manage a rare case of paraspinal paraganglioma in an 8-year-old female. Background: Functional paraspinal paragangliomas are exceptionally rare entities in both adult and pediatric age groups. These tumors are closely associated with major vascular structures like the aorta and are in close proximity to the spinal nerves and threatened with deadly vascular complications (e.g., hemorrhagic shock) and neurological complications (e.g., paralysis or paresis of the lower limb). So managing pediatric patients with safe outcomes is a challenge. Case description: An 8-year-old female child presented with a two years history of headache, palpitations, sweating, and high blood pressure with no neurological deficit. On evaluation, she was found to have elevated urinary normetanephrine levels and a left lateral paraspinal mass located at the level of T7–T11 vertebral bodies on imaging. She was managed with preoperative alpha-adrenergic blockade followed by complete tumor resection. Conclusion: Biochemical evaluation, perioperative care with adequate α-blockade, and timely follow-up is necessary for best outcomes in functional paraspinal paraganglioma. Clinical significance: High suspicion of an index and multidisciplinary teamwork were key in diagnosing and managing this rare tumor.
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小儿椎旁副神经节瘤:罕见病例报告
目的:治疗一例罕见的8岁女性椎旁副神经节瘤。背景:功能性脊旁副神经节瘤在成人和儿童年龄组中都非常罕见。这些肿瘤与主动脉等主要血管结构密切相关,与脊神经非常接近,并有致命的血管并发症(如失血性休克)和神经并发症(如下肢瘫痪或轻瘫)的威胁。因此,以安全的结果管理儿科患者是一项挑战。病例描述:一名8岁的女性儿童,有两年头痛、心悸、出汗和高血压病史,无神经系统缺陷。在评估中,她发现尿中去甲肾上腺素水平升高,影像学上左侧棘旁肿块位于T7–T11椎体水平。她接受了术前α-肾上腺素能阻滞剂治疗,随后进行了肿瘤完全切除。结论:对功能性棘旁副神经节瘤进行生化评估、围手术期给予适当的α-阻断治疗和及时随访是取得最佳疗效的必要条件。临床意义:对一项指标的高度怀疑和多学科团队合作是诊断和治疗这种罕见肿瘤的关键。
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