PMC7749962_01
(a) Axial T1-W sequence demonstrate hypointense characteristics of the tumor expanding the thickness of the spinal cord. (b) Axial T1-W with Gd shows a moderate homogenous enhancement without a clear difference from the medullary tissue. (c) Sagittal view on T2-W sequence made clear that the tumor that extended from the superior border of Th11 to the inferior border of Th12. An adjacent cranial lobulated syrinx extending from Th11 to Th4 was observed. (d and e) Axial T2-W images of the spinal cord and filum terminals confirmed hyperintense characteristics of the tumor with a foamy-like characteristic and differentiated from spinal cord tissue. (f) Post-surgical sagittal T2-W sequence rules out tumor recurrence and decrease in the size of the syrinx (3 years later).
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F1
T1-W sequence expanding the thickness of the spinal cord and filum terminalis, a moderate homogenous enhancement was noticed after Gadolium injection [Figure 1b]. T2-W sequences confirmed an hyperintense lesion occupying almost the whole diameter of the spinal cord with foamy-like well-defined characteristics that extended from the superior border of Th11 to the inferior border of Th12, remarkable spinal cord, and filum terminalis vasogenic edema could be observed. Cranial syrinx was evident immediately adjacent to the tumor and extended from Th11 to Th4 with an important intramedullary cystic cavity [Figures 1c-e]. Tumor recurrence is discarded after 24 months of follow-up MRI [Figure 1f].
(a) Panoramic photomicrograph (x10) demonstrating proliferation of monotone cellularity with clear cytoplasm and round nuclei. (b) (x40) Most of the tumoral cells show a high nuclear-to cytoplasm ratio with round or slightly oval nuclei and a clear perinuclear halo. (c) Pseudorosettes, as perivascular cuffs of tumoral cells with processes oriented towards the central vessel are visualized in a non-organized mode (H and E Stain).
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F2
Entrapped blood vessels showed moderate perivascular hyalinization and the presence of pseudorosettes suggesting; thus, the diagnosis of CCE without anaplasia [Figure 2].
(a) Intense citoplasmic positivity for glial fibrillary acid protein (PGAF Bio SB. Clone G-A-5). (b) Positive immunemarker for Ki-67, 3+ in 1% of tumoral cells (Ki-67 RMab-Bio SB. Clone EP5).
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F3
Immunohistochemical analysis results consisted in a strong positivity (3+) to anti-glial fibrillary acidic protein (GFAP) with a Ki67 (MIB-1) labeling index at 1%, and negative for both chromogranin A and anti-epithelial membrane antigen (EMA) antibodies [Figure 3].