Observation:
A 51-years-old male with no pathological background presented after the
onset of a sudden numbness in his lower extremities associated to
urogenital disorders. Physical examination revealed a cauda equine
syndrome. Deep-tendon reflexes were abolished in both lower limbs with
bilateral foot dorsiflexion weakness (2/5). Hypoesthesia of the lower
left extremity as well as saddle anaesthesia was also found. Magnetic
resonance imaging (MRI) of the lumbar spine was performed. It showed an
intradural well-circumscribed mass extended from L1 to L3. The mass was
isointense on T1 weighted images, hyper intense on T2 weighted images
with homogenous enhancement after Gadolinium injection (figure 1).
Urgent lumbar laminectomy and total resection of a highly vascularized
haemorrhagic intradural tumour was performed (Figure 2). No tight
adherence were noticed with nerve roots, and tumour resection was
macroscopically complete. Pathologic examination of the specimen (Figure
3) concluded to a paraganglioma. The patient had a good postoperative
recovery as well as an improvement of neurological signs. A 2 years
follow up did not show neither clinical nor radiological signs of
recurrence.