PMC9805658_01
Case 1. Sagittal T1-weighted (a), T2-weighted (b), and post contrast (c) images of the cervical spine show presence of a bulky, expansile, and elongated mass in the medulla and spinal cord upto the C6 vertebral level. Intrinsic T2 hypointensity in the cranial portion (black arrow), tiny cystic foci (thin black arrows), and hyperintense edema (white arrow) are seen in (b). Minimal patchy enhancement is seen in (c) (white arrow).
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F1
Magnetic resonance imaging (MRI) of the cervical spine revealed an elongated, bulky, and expansile mass lesion extending from the superior margin of the medulla with a dorsally exophytic component, and caudally was up to C6 vertebral level [Figure 1].
Case 1. Axial T2-weighted (a-c) and post contrast T1-weighted (d) images reveal dorsal exophytic extension in (a) (white arrow), asymmetric involvement, more in the left hemicord (long white arrow), and cystic focus (thin white arrow) in (b), intrinsic T2 hypointensity in (c) (black arrow) and minimal enhancement in (d) (white arrow).
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F2
In the axial images, asymmetric involvement was noted; the left hemicord was more affected than the right [Figure 2].
Case 1. (a) Postoperative T2-weighted sagittal image of the cervical spine shows complete excision of the mass. (b) Histopathology showing foci of microvascular proliferation suggestive of glioblastoma (Hematoxylin and Eosin x40 magnification).
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F3
Postoperative MRI done 2 days after surgery showed complete excision of the lesion along with postoperative edema and changes in the tumor bed [Figure 3].
Case 2. Sagittal T2-weighted (a) and post contrast sagittal (b) and coronal (c) images of the cervical spine show a bulky, expansile, and heterogeneously enhancing mass in the lower medulla and spinal cord upto C5 vertebral level. T2 hyperintense edema (white arrow) is shown in (a).
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F4
MR imaging showed an expansile intramedullary lesion extending from the cervicomedullary junction to the C5 vertebral body appearing heterogeneously hyperintense on the T2W image and isointense on the T1W image [Figure 4].
Case 2. Sagittal T2-weighted (a) and post contrast T1-weighted (b) images of the cervical spine reveal marked excision of the mass lesion with postoperative changes. (c) Histopathology showing neurofibrillary background and pleomorphic cells suggestive of glioblastoma (Hematoxylin and Eosin, x40 magnification).
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F5
MRI [Figure 5]. Multimodal intraoperative neuromonitoring was used during surgery.