Extradural paraganglioma with multiple skeletal metastases

Tumours arising from the paraganglia (paragangliomas) are characteristically of low malignant potential, with only 10% developing distant metastases (North et al, 1990). Malignancy in paragangliomas is defined either by local invasion or spread to distant sites normally devoid of paraganglia (Irons et al, 1977; Jackson et al, 1982). We present a case with several unusual features: (1) the primary site of the tumour is in the extradural space at D7 and L3 levels (lesion at L3 not biopsied), (2) multiple skeletal metastases at a short interval after primary diagnosis, and (3) absence of mitoses both in the original specimen and the metastatic deposit. A 29-year-old man presented in December 1989 with girdle pain in the upper abdomen for 3 months, descending numbness and paraparesis for 3 weeks and incontinence for 1 week.