Paraganglioma of the Lumbar Spine: A Case Report.

Paragangliomas are rare neuroendocrine tumors, with spinal involvement representing a small minority of cases. Lumbar spinal paragangliomas are especially uncommon and may present with nonspecific symptoms, often mimicking more common intradural tumors. We describe a 49-year-old female who presented with chronic low back and sacral pain, along with bilateral lower extremity symptoms. Lumbar MRI demonstrated an intrathecal, homogeneously enhancing mass at L3 causing canal stenosis. The patient underwent lumbar laminectomy with gross total resection of an intradural, extramedullary lesion. Histopathology confirmed a paraganglioma, with immunohistochemical positivity for chromogranin A, synaptophysin, and S100. Postoperatively, she reported substantial relief of pain and radiculopathy, with no neurological deficits. Surveillance MRI at seven weeks and 4.5 months showed no residual or recurrent tumor. Although rare, lumbar paragangliomas should be considered in the differential diagnosis of intradural, extramedullary masses. Gross total surgical resection offers effective symptom relief and favorable short-term outcomes. Given the potential for delayed recurrence, we recommend close postoperative surveillance with MRI every three to six months during the initial follow-up period.