PMC10408635_01
(a) Preoperative axial and sagittal cut of magnetic resonance imaging (MRI) (T2) cervical spine showing a well-defined heterogeneous mass in the right carotid space in the neck extending from C1 to T1 levels. (b) Preoperative axial and sagittal cut of MRI (T2) lumbar spine showing another a large intraspinal extradural mass with similar intensity in the lumbar spine at the level of L1-L3. There is scalloping and sclerosis as well as abnormal enhancement of the L2 vertebral body secondary to tumor involvement.
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F1
It measures 4.8 x 4.9 cm in the anterior-posterior and transverse planes, respectively [Figure 1a]. T2 hyperintense with a well-circumscribed mass centered in the left neural foramen of the L2 vertebra (L2/L3), extending to L1/L2 foramen with a large intraspinal extradural component and an extraspinal component extending into the left paravertebral muscles with a tumor bulk measuring 6.2 x 2.9 x 5.9 cm in the anterior-posterior, transverse, and craniocaudal planes, respectively [Figure 1b]. The patient underwent a computed tomography (CT)-guided biopsy of the lumbar lesion, which confirmed the presence of a malignant peripheral nerve sheath tumor (grade II).
PMC10408635_02
(a) Axial cut of magnetic resonance imaging (MRI) brain (fluid-attenuated inversion recovery) showing bilateral hamartoma in globus pallidus. (b) Preoperative sagittal and coronal cut MRI T2 of lumbar spine showing an ill-defined mass at the level of L3-5. (c) Preoperative sagittal and coronal cut MRI T2 of the cervical spine showing a predominantly hypodense well-defined mass found in the right retropharyngeal space.
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F2
An MRI brain scan showed a stable hyperintensity focus on T2 within the left occipital lobe, which was stable since November 2016 and a bilateral globus pallidus hamartoma that is larger in the right side [Figure 2a]. The mass measured 6.6 x 7.6 x 8.7 cm in the anterior-posterior, transverse, and craniocaudal planes, respectively, and extended transforaminal to the abdomen [Figure 2b]. An MRI scan showed recurrence in the right retropharyngeal MPNST measuring 3.3 x 2.1 x 5.1 cm in the anterior-posterior, transverse, and craniocaudal planes, respectively [Figure 2c].