PMC10159297_01
Magnetic resonance imaging of the cervical spine. (a) Sagittal T2-weighted revealed a syrinx with an intramedullary expansive lesion. (b) Sagittal T1-weighted dixon Gadolinium (Gd) enhancement image revealing an intramedullary intradural hyperintense mass (red arrow) at the T1-T2 level.
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F1
The magnetic resonance imaging (MRI) demonstrated an intramedullary expansive lesion at the T1-T2 level that markedly enhanced with contrast; it was also accompanied by cephalad and caudad hydromyelia [Figures 1 and 2].
Axial T1-weighted image with Gd enhancement demonstrates the posterolateral hyperintense lesion infiltrating the spinal cord located in the posterior arch of T1.
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F2
The magnetic resonance imaging (MRI) demonstrated an intramedullary expansive lesion at the T1-T2 level that markedly enhanced with contrast; it was also accompanied by cephalad and caudad hydromyelia [Figures 1 and 2].
Posterolateral sulcus approach for the thoracic spinal cord intramedullary tumor. Tumor (yellow arrow).
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F3
Using microscope visualization and intraoperative monitoring, the dura was opened revealing an expansive and very vascular intramedullary cord lesion [Figure 3].
Macroscopic complete resection of the spinal cord lesion.
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F4
A cleavage plane between the tumor and cord facilitated gross-total operative resection of the lesion using the cavitron ultrasonic surgical aspirator device [Figure 4].
(a and b) Histopathological examination with hematoxylin and eosin staining revealed a large and vacuolated stromal cells, and intertwined with thin-walled capillaries, and clear cytoplasm. Immunohistochemical staining with inhibin A showing marked positivity of the neoplastic cells.
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F5
Immunohistochemical staining revealed stromal cells positive for inhibin A, S100, and CD31, and was immunonegative for CD56, and AE1-3 [Figure 5].
(a and b) Follow-up magnetic resonance imaging showing gross total removal of the hemangioblastoma (HBL) and reduction of the syrinx.
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F6
One-year later, the patient was fully neurologically intact, and the magnetic resonance (MR) continued to confirm the lack of tumor recurrence along with further reduction of the cephalad/caudad syrinxes/ hydromyelia [Figure 6].