A Man with Abdominal Pain, Foot Drop, and a Spinal Mass

His blood pressure was 192/91 mm Hg on hospital admission. Imaging showed a hypervascular thoracic spinal mass with epidural extension causing cord compression. Serum and urine catecholamines were elevated, and biopsy showed a zellballen pattern (German for “ball of cells”; Figure 1). These findings were consistent with a spinal paraganglioma, which interestingly had also affected his father. The patient was treated with surgical resection, with preceding spinal angiography and embolization to reduce potential bleeding, as well as α-adrenergic blockade to prevent an intraoperative hypertensive crisis.