{"id":"6392ed59-3c3b-401a-90a4-8392944cc6bd","slug":"a-rare-case-of-cauda-equina-paraganglioma-histologically-simulating-ependymoma","title":"A rare case of cauda equina paraganglioma histologically simulating ependymoma","authors":["Ebrahim Mohamd Kher Alyousef","Bashayer Abdulla Alshamsi","Mahra Ali Almazrouei","Ammar Shahid Tanweer","Tasnim Ebrahem Alyousef","Elaf Ebrahem Alyousef"],"abstract":"Background: Paragangliomas of the cauda equina are rare neuroendocrine tumors that can mimic ependymomas on imaging and histology, creating diagnostic challenges and influencing surgical planning. Case Description: A 41-year-old man presented with progressive low back pain and bilateral leg numbness. MRI showed a well-circumscribed, enhancing intradural extramedullary mass at L3. He underwent L3–L4 laminectomy with gross-total microsurgical excision. Histopathology revealed pseudorosettes and uniform tumor cells, initially suggesting ependymoma; however, immunohistochemistry demonstrated strong synaptophysin and S100 positivity with negative GFAP and EMA, confirming a cauda equina paraganglioma. Postoperatively, the patient recovered fully and remained asymptomatic at 1-year follow-up. Conclusion: Paragangliomas can closely resemble ependymomas, and accurate diagnosis requires immunohistochemistry. Complete surgical excision yields excellent outcomes, and individualized long-term imaging follow-up is recommended because recurrence, although uncommon, can occur.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/6392ed59-3c3b-401a-90a4-8392944cc6bd/featured/hero-1781558134964.png","publishDate":"2025-12-05T00:00:00.000Z","doi":"10.25259/SNI_812_2025","categories":["Neuro-oncology","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2025/12/14128/SNI-16-513.pdf"}