PMC2815846_01
A and B: Pre-operative CT scan with bone setting reveals extensive erosion with marginal sclerosis in the right transverse process and superior articular facet of C-1 (white triangle).
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F1
The pre-operative computed tomography (CT) scan revealed extensive erosion with a marginal sclerosis or destructive pattern involving the right transverse process and articular facet of C-1 (Fig. 1).
(A, B) Axial T1-weighted MRI scan reveals a multilobulated mass involving the lateral mass of C-1 and enhancing moderately with indefinite tumor margin (white triangle). (C) Coronal T2-weighted MRI scan reveals mass in the right articular facet of C-1 spine (white triangle). (D) After 1 year, MRI scan demonstrates the remnant of the tumor after radiotherapy (white arrow).
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F2
Axial and coronal magnetic resonance imaging (MRI) scans revealed a multilobulated mass that aggressively invaded the lateral mass of C-1 and had moderate enhancement with the indefinite tumor margin (Fig. 2). Follow-up MRI scans showed good stability of the atlanto-axial joint, but revealed remnants of the tumor which required the patient to undergo radiotherapy (Fig. 2).
Histological examination reveals a schwannoma composed of interwoven bundles of spindle-shaped, fibrillated cells (hematoxylin and eosin, 200x, A) and immunopositivity for vimentin(200x, B) and S-100 (200x, C).
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F3
The histopathological diagnosis was a benign schwannoma composed of interwoven bundles of spindle-shaped, fibrillated cells (Fig. 3).