PMC9852823_01
(A) Preoperative transverse and sagittal CT showed no bone destruction in the cervicothoracic junction. (B) Preoperative lung CT showed no obvious signs of tumor metastasis,Six months after the operation, lung CT showed multiple nodules in both lungs, and metastasis was considered. (C) T1-weighted, T2-weighted, and fat-suppressed sagittal MRI showed a long tubular mass in the spinal canal at the cervicothoracic junction, with a size of about 8 mm x 15 mm x 63 mm, and no abnormal signal vertebral body and appendage morphology.
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F1
MRI showed that the tumor in the cervicothoracic spinal canal was approximately 8 mm x 15 mm x 63 mm (Figure 1). Pulmonary metastases occurred after 6 months of follow-up with no local recurrence (Figure 1).
(A) Severe dural sac compression before surgery, (B) intraoperative excision of the tumor, about 5 cm long, (C) the dural sac was entire and pulsating after tumor resection, (D) postoperative radiographs showed accurate pedicle screw placement.
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F2
Pedicle screws were placed on both sides of C7 and T3, the right side of T1 and the left side of T2 to fix the unstable cervical spine.C7 and T3, the right side of T1 and the left side of T2 to fix the unstable cervical spine (Figure 2). The tumor was completely separated out and excised along the envelope under microscopic manipulation, the dura mater was intact and pulsatile, and the lesion was biopsied (Figure 2).
(A) Pathological examination microscope showed small round blue cells (HE staining, x200). (B-D) Immunohistochemical staining showed that vimentin (B), CD99 (C) and Cyclin D1 (D) were strongly positive in small round blue cells (x100).
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F3
The histopathological report showed malignant small round blue tumors, which is consistent with Ewing's sarcoma/PNET (Figure 3).