0:01

As neuroradiologists,

0:02

when we think about paragangliomas,

0:04

we usually are thinking about head and neck lesions,

0:07

and those would include our glomus tympanicum

0:10

tumors in the middle ear cavity,

0:11

our glomus jugulare tumor in the jugular foramen, our

0:16

carotid body tumor at the carotid bifurcation,

0:20

and our glomus vagale tumor at the

0:22

C1-C2 skull base region.

0:25

And these are the typical locations for paragangliomas.

0:28

Rarely, you will see a paraganglioma in the same

0:31

general vicinity as where we see myxopapillary

0:36

ependymomas, and that is down here at the

0:38

cauda equina and filum terminale.

0:41

These lesions will be characterized by avid contrast

0:45

enhancement and relatively low incidence

0:49

of cystic change or hemorrhagic change.

0:53

Very rarely you will see it as a hypervascular

0:56

lesion with flow voids associated with it.

0:59

And you will see it as this intensely enhancing

1:03

tumor on the post-gadolinium-enhanced scan.

1:07

So we'll have a differential diagnosis which

1:09

would include all of the other tumors,

1:10

including schwannomas, meningiomas,

1:13

as well as the filum terminale ependymomas.

1:17

So again,

1:18

the feature that would be most helpful is the very

1:21

avid enhancement that you expect with paragangliomas

1:24

and if present, vascular flow voids.

Spinal Paraganglioma

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