The Management Of Incidental Serious Pathology During Elective Anterior Lumbar Spine Surgery: A Case Of Retroperitoneal Paraganglioma And Review Of The Literature

摘要

Pheochromocytoma is a rare tumour arising from cells of neural crest origin. The majority occur in the adrenal medulla. 10% occur elsewhere in the sympathetic nervous system when they are referred to as paragangliomas. 90% of paragangliomas arise in the glomus jugulare or carotid bodies. 10% are found elsewhere, from the skullbase to the pelvis. This case report discusses the investigation and management of metastatic paraganglioma discovered during anterior spinal surgery. With increasing numbers of spinal surgeons using anterior approaches to the lumbar spine to implant disc replacements, the need to be prepared to manage unexpected and unfamiliar pathologies, within the retroperitoneum, is clear. There is one report of a retroperitoneal paraganglioma presenting with cauda equina compression secondary to local invasion, in the literature. We believe that this is the first report of this tumour being discovered during elective anterior spinal surgery.