PMC3291709_01
Preoperative MRI showing abnormal signal intensities on epidural dumbbell-shaped mass (measuring 25x18x24 mm) traversing the C1 to C2 interspinous space, compressing surrounding structures. The dumbbell-shaped lesion reveals isointense on sagittal T1-WI (A), mixed hypointense on T2-WI (B), and well-enhanced after gadolinium administration (C). The spinal cord was compressed at the C2 level, and the signal change appeared on T2-WI. MRI : magnetic resonance images, WI : weighted image.
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F1
CT scan showed cortical osseous erosions at the lower C1 posterior arc and upper C2 spinous process. Cervical magnetic resonance images (MRI) revealed an epidural dumbbell-shaped mass traversing the C1 to C2 interspinous space, compressing the surrounding structures (Fig. 1).
Post-operative CT scan. Partial hemilaminectomy, from the lower half of the C1 posterior arch to upper half of C2 spinous process, was performed (A : mid-sagittal, B : 3-dimensional reconstruction). C : Follow-up MRI with enhancement after postoperative 2 years reveals no residual and no recurrence. CT : computed tomography, MRI : magnetic resonance images.
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F2
Under microscopy, the tumor was delicately dissected, and en bloc removal was achieved (Fig. 2).
Photomicrographs of the tumor reveals focal aggregation of cells with ample, clear, and foamy cytoplasm. There are large round cells with irregular vesicular nuclei. H&E, original magnification x200.
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F3
Upon sectioning, the mass was particularly yellow and white with cystic components (Fig. 3).
Gross finding of the tumor. A : External surface of the tumor; ovoid, yellowish, encapsulated with a white-colored adhesion scar at the mid-portion of the mass shown in the picture. B : Mid-section of the tumor, particularly yellow and white with cystic components.
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F4
Cervical MRI with gadolinium enhancement at 2 years after surgery demonstrated no recurrent lesion (Fig. 4). Large, round cells had irregular vesicular nuclei which were regular and small with condensed chromatin (Fig. 4).