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Abstract

Background: Paragangliomas originate from peculiar type of cells derived from neural crest origin, and are relatively sparse in presence.Most often these are originated with in the adrenal glands.Origin with in the spinal canal is rare, however when present, they are found in the intradural extramedullary compartment in lumbosacral region.They are usually indolent and considered WHO grade I lesions.Patient presents with symptoms of lower back pain which radiates into the lower extremities.Patients may also present with sensory or motor neural impairment.Case Report: We present a case of a 33-year-old male initially presented with bilateral sciatica and recumbent back pain.Mild urinary urgency for over last one month was also noted.MRI scan performed which demonstrated a homogenously enhancing intra dural, extra medullary nodule at the level L2 vertebral body.Radiologically this was interpreted as ependymoma versus meningioma.Neurosurgical consult recommended due to mass effect on the adjacent cauda equina nerve roots.Laminectomy was performed and excision was done of this space occupying lesion.The histopathology turned out to be paraganglioma versus neuroendocrine tumor.Practical Implications: Paragangliomas and neuroendocrine tumors of spine are a rare entity.They can be misdiagnosed on imaging as they have similar or overlapping features of that of the meningioma or ependymoma.The purpose of this case report is to make radiologists aware regarding the rare entities come under differential diagnosis of intradural extra-medullary tumors.To a greater extent a combination of clinical, pathological and imaging correlation should be done for better diagnosis.