Metastatic paraganglioma presenting with spinal cord compression requiring urgent surgery

被引:1
作者
Gauci, Zachary [1 ]
Imbroll, Miriam Giordano [1 ]
Giusti, Ebony Sciberras [1 ]
Agius, Shawn [2 ]
Gruppetta, Mark [1 ]
机构
[1] Mater Dei Hosp, Dept Endocrinol & Gen Med, Msida, Malta
[2] Mater Dei Hosp, Dept Neurosci, Msida, Malta
关键词
Adrenal disorders; Spinal cord; Cancer; Neurosurgery; URINARY-BLADDER; MALIGNANT PHEOCHROMOCYTOMA; THERAPY; SURVIVAL; CYCLOPHOSPHAMIDE; VINCRISTINE; MANAGEMENT; SUNITINIB; BLOCKADE; EFFICACY;
D O I
10.1136/bcr-2023-256052
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We report a rare case of a functional bladder paraganglioma diagnosed in a young man who presented with acute compressive thoracic myelopathy secondary to vertebral metastasis. A histological diagnosis of a metastatic paraganglioma was made following biopsy of a rib lesion. CT revealed a lesion in the inferior wall of the bladder, which demonstrated avid uptake on 68Ga-DOTATATE PET/CT. Serum metanephrine levels were more than 40 times the upper limit of normal. The patient was hypertensive and treatment with doxazosin was initiated. In view of neurological deterioration, he required urgent spinal decompression to preserve neurological function and prevent permanent paraplegia. Despite inadequate alpha-blockade, surgery was successful, and the perioperative course was uneventful. Alpha-blockade was subsequently optimised. Treatment with cyclophosphamide, vincristine and dacarbazine was started but, in view of disease progression, treatment was subsequently changed to sunitinib.
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页数:5
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