PMC10198211_01
Graph showing laboratory biochemical data from the onset of detection to date
JCVJS-14-97-g001.jpg
PMC10198211_01_JCVJS-14-97-g001.jpg
F1
The data for the months from the onset of detection of HPT to date are presented in Table 1 and Figure 1.
MRI of the cervical spine - T2WI (A: Sagittal, B: Axial, C: Coronal) showing an expansile lytic lesion involving the C2 vertebra, causing collapse with posterior impingement on the thecal sac and cord. MRI: Magnetic resonance imaging
JCVJS-14-97-g002.jpg
PMC10198211_01_JCVJS-14-97-g002.jpg
F2
MRI and CT scans of the cervical spine were repeated, which revealed an expansile lytic lesion involving the vertebral body, odontoid process, and left pedicle of the C2 vertebra and as compared to the prior study, there was a moderate interval increase in the lesion, causing collapse with posterior and left lateral subluxation, impinging on the thecal sac and cord [Figures 2 and 3].
CT of the cervical spine - (A: Sagittal, B: Axial, C: Coronal) showing an expansile lytic lesion (red arrows) involving the vertebral body, odontoid process, and left pedicle of C2 vertebra, causing collapse with posterior and left lateral subluxation; diffuse radiologic lucencies (osteopenia vs. multiple lytic lesions) in the other visualized bones including multiple vertebrae (blue arrows). CT: Computed tomography
JCVJS-14-97-g003.jpg
PMC10198211_01_JCVJS-14-97-g003.jpg
F3
MRI and CT scans of the cervical spine were repeated, which revealed an expansile lytic lesion involving the vertebral body, odontoid process, and left pedicle of the C2 vertebra and as compared to the prior study, there was a moderate interval increase in the lesion, causing collapse with posterior and left lateral subluxation, impinging on the thecal sac and cord [Figures 2 and 3].
H and E stained histopathology sections showing scanty fragments of viable and necrotic cortical bone with very scanty fragments of fascicles of spindle-shaped fibrous stromal cells with bland nuclear features and admixed few osteoclastic giant cells and foci of hemosiderin-laden macrophages and focal new bone formation; no evidence of cytologic atypia, mitosis or malignant chondroid, or osteoid; no evidence of malignancy or metastasis
JCVJS-14-97-g004.jpg
PMC10198211_01_JCVJS-14-97-g004.jpg
F4
Postoperative AP and lateral X-ray showing occipitocervical fusion with implants in situ. AP: Antero-Posterior
JCVJS-14-97-g005.jpg
PMC10198211_01_JCVJS-14-97-g005.jpg
F5
The patient improved neurologically postsurgery with good progress on follow-up [Figure 5].