PT - JOURNAL ARTICLE AU - Rashad Jabarkheel AU - Arjun V. Pendharkar AU - Jonathan L. Lavezo AU - Justin Annes AU - Kaniksha Desai AU - Hannes Vogel AU - Atman M. Desai TI - Metastatic Paraganglioma of the Spine With <em>SDHB</em> Mutation: Case Report and Review of the Literature AID - 10.14444/7163 DP - 2021 Feb 01 TA - International Journal of Spine Surgery PG - S37--S45 VI - 14 IP - s4 4099 - http://ijssurgery.com//content/14/s4/S37.short 4100 - http://ijssurgery.com//content/14/s4/S37.full SO - Int J Spine Surg2021 Feb 01; 14 AB - Background: Paragangliomas (PGLs) are rare neuroendocrine tumors that can arise from any autonomic ganglion of the body. Most PGLs do not metastasize. Here, we present a rare case of metastatic PGL of the spine in a patient with a germline pathogenic succinate dehydrogenase subunit B (SDHB) mutation.Methods: In addition to a case report we provide a literature review of metastatic spinal PGL to highlight the importance of genetic testing and long-term surveillance of these patients.Results: A 45-year-old woman with history of spinal nerve root PGL, 17 years prior, presented with back pain of several months' duration. Imaging revealed multilevel lytic lesions throughout the cervical, thoracic, and lumbar spine as well as involvement of the right mandibular condyle and clavicle. Percutaneous biopsy of the L1 spinal lesion confirmed metastatic PGL and the patient underwent posterior tumor resection and instrumented fusion of T7–T11. Postoperatively the patient was found to have a pathogenic SDHB deletion.Conclusions: Patients with SDHx mutation, particularly SDHB, have increased risk of developing metastatic PGLs. Consequently, these individuals require long-term surveillance given the risk for developing new tumors or disease recurrence, even years to decades after primary tumor resection. Surgical management of spinal metastatic PGL involves correcting spinal instability, minimizing tumor burden, and alleviating epidural cord compression. In patients with metastatic PGL of the spine, genetic testing should be considered.