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previously visited 10-YEAR-OLD MALE WITH POSTERIOR MEDIASTINAL MASS Random Case
Authored By: Faculty and residents Children's Hospital, Radiologist, Children's Health System, Birmingham, Alabama., USA.
Patient: 10 year old male
History: 10 year old male who presented with back pain.
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Fig. 6: T1 +C
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Findings: Large posterior mediastinal mass with heterogeneous enhancement.  This mass extends posteriorly through neuroforamina at several levels and invades the central canal causing thoracic cord compression.  Dilated, enhancing vessels are seen internally on CT that correspond to vascular flow voids on MR.  Bony remodeling and some erosions is noted involving the adjacent ribs posteriorly.
DDx: Metastasis
Ewing's sarcoma
Paraganglioma
Neuroblastoma
Diagnosis: Spinal Paraganglioma
Discussion:

Paraganglioms are rare neoplasms that arise from neural crest cells associated with autonomic ganglia located throughout the body.  Most of these tumors occur in the adrenal medulla, in which case they are generally referred to as either functioning or nonfunctioning pheochromocytomas.  A majority (80-90%) of extra-adrenal paraganglioms are associated with the carotid body/jugular bulb (glomus tumors).  These tumors are generally considered benign (WHO I).  However, some are aggressive and can even metastasize.  Large masses, such as this, can present with bony remodeling or erosion. Extraadrenal paragangliomas are less likely to have secretory activity. An MIBG radionuclide scan can indicate functionality of the lesion as well as detection of circulating catecholamines.

This mass was resected. Further scans showed no evidence of metastasis or lymphadenopathy. At 2 years post-op, there has been no recurrence.

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Additional Details:

Case Number: 22852974Last Updated: 03-02-2009
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Anatomy: Spine and Peripheral Nervous System   Pathology: Neoplasm
Modality: CT, MRAccess Level: Readable by all users

Case has been viewed 288 times.

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