PMC8253935_01
T2 weighted magnetic resonance imaging of the lumbar spine: coupled extradural cystic high intensity tumors on sagittal view (A) and axial view (B). Arrows demonstrating displacement of the L4-5 thecal sac and cauda equina with an extension into the corresponding right neuroforamen. Intraoperative photograph (C) showing the extradural tumor (black arrow) located at the right side of the dural sac (white arrow).
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Axial-sagittal magnetic resonance imaging (MRI) revealed extradural cystic tumors causing moderate indentation and displacement of the L4-5 thecal sac and cauda equina, together with an extension into the corresponding right neuroforamen (Figure 1A and B). The masses were macroscopically extradural, tophaceous, and soft (Figure 1C).
Histopathological photomicrograph: hematoxylin-eosin stain, magnification x200 (A) and hematoxylin-eosin stain with polarization gating, magnification x200 (B) showing numerous pathognomonic positively birefringent rhomboidal crystals (white arrow).
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Microscopically, the specimen consisted of countless weakly positive birefringent rhomboid shaped crystals when examined under polarized light (Figure 2A and B).