By: Belinda Zorielie Burgos González
Latin Agency for News of Medicine and Public Health
Back pain in the lower back may be common today, due to injuries to the lower back for different physical and clinical reasons. This time, the pain produced in a 42-year-old man came from a rare pathology contained mostly in the letters of the literature.
In Puerto Rico, doctors came across a patient referred by his primary doctor to be evaluated for continuous back pain and after the results of an “MRI” study, when a mass was found on the back, specifically at the previous L5 level, he said. In an interview with Medicine and Public Health (MSP) Dr. Carlos Castro, part of the team that evaluated the case.
The patient arriving at Auxilio Mutuo hospital underwent a radiological study – “CT” – and a biopsy, where a paraganglioma (PG) was surprisingly found.
This rare tumor is one that originates from nerve cells throughout the body. It can affect people of any age, but it occurs most often in people ages 30 to 50. Its growth can be slow and manifest as benign or malignant and can spread to remote areas (metastasis).
Symptoms include high blood pressure, rapid heartbeat, red skin, sweating, headaches, and tremors.
Surgery to remove the tumor is usually the first treatment option for paraganglioma, if possible. If left untreated, paraganglioma can cause serious or life-threatening damage and can progress to the point where surgical treatment is not an option.
“The biopsy showed cells that are consistent with the diagnosis of paraganglioma. The patient was referred to MD Anderson Cancer Hospital in Texas. This tumor is extremely rare. The incidence is 0.8% per 100,000 inhabitants. When this tumor is diagnosed after back pain, it is a very atypical case ”, confirmed the doctor to MSP.
“At the hospital (MD Anderson Cancer Center) he had surgery and a genetic study that revealed a mutation for the SDH gene (” succinate dehydrogenase enzyme, “a mitochondrial enzyme), which is even rarer. This mutation tends to occur in patients when they are in their 40s, precisely the age of this patient. At the time of diagnosis the patient had a metastasis process and did not have a tumor, he had two tumors. This scenario teaches us that we always have to delve into the diagnoses and learn about these atypical clinical presentations “, he added.
Another important aspect that the doctor highlighted is that the mutation that this patient presented -gen SDH- is a family one, so the team of clinicians advised his family about the importance of the group undergoing a genetic analysis due to the high possibility that they could also possess it.
It should be noted that the surgery performed on this patient was curative, since the patient was tumor free.
However, the tumor could recur and in the literature there is not much information on the specific recurrence of this pathology, concluded Dr. Castro.
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