PMC7771502_01
Preoperative magnetic resonance imaging (MRI). (a) Sagittal view of the lumbosacral spine T1-weighted without contrast showing an isointense signal lesion in the conus medullaris. (b) MRI sagittal view of the T2-weighted lumbosacral spine showing hyperintense conus medullaris signal. (c) Sagittal MRI of the lumbosacral T1-weighted spine after gadolinium injection, heterogeneous contrast enhancing in conus medullaris, an apparently infiltrative lesion. (d) Sagittal section of the dorsal column and lumbosacral showing extensive syringomyelia in the thoracic spinal cord.
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F1
The thoracolumbar magnetic resonance image (MRI) showed a conus medullaris mass; T2-weighted images demonstrated a T9-T12 syrinx, while the enhanced T1 study showed a heterogeneously enhancing mass [Figure 1].
(a-c) Hematoxylin and eosin (H&E) staining showing numerous granulomatous fragments of fibrotic and neural tissue and lymphomononuclear inflammatory infiltrate rich in eosinophils forming granulomatous nodules with necrotic center enclosing parasites with the characteristic spicula of consistent in appearance with Schistosoma mansoni.
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F2
The patient was discharged 5 days later with the same preoperative paraparesis; when the final pathology confirmed conus medullaris schistosomiasis, the patient underwent subsequent treatment with praziquantel (20 mg/kg) [Figure 2]. Three months later, the postoperative MRI showed no residual lesion [Figure 3].
Postoperative magnetic resonance image of the thoracolumbar spine showing the absence of anomalous contrast areas in addition to the absence of recurrence of the lesion.
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F3
The patient was discharged 5 days later with the same preoperative paraparesis; when the final pathology confirmed conus medullaris schistosomiasis, the patient underwent subsequent treatment with praziquantel (20 mg/kg) [Figure 2]. Three months later, the postoperative MRI showed no residual lesion [Figure 3].