PMC7276609_01
Scalloping of L1 vertebral body.
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F1
Plain radiographs of the lumbosacral spine showed scalloping of the anterior border of L1 vertebra and degenerative changes lower down at L4-L5(Fig. 1).
Magnetic resonance imaging picture post-contrast enhancement showing hyperintense lesion causing destruction of L1 vertebra.
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F2
Magnetic resonance imaging (MRI) of the lumbar spine revealed heterogeneously enhancing retroperitoneal lesion at L1 with areas of necrosis (Fig. 2-4).
Axial non-contrast T2-weighted magnetic resonance imaging shows isointense lesion clearly demarcated.
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F3
Magnetic resonance imaging (MRI) of the lumbar spine revealed heterogeneously enhancing retroperitoneal lesion at L1 with areas of necrosis (Fig. 2-4).
Sagittal T2-weighted non-contrast magnetic resonance imaging showing iso-to hypo-intense lesion adjacent to L1.
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F4
Magnetic resonance imaging (MRI) of the lumbar spine revealed heterogeneously enhancing retroperitoneal lesion at L1 with areas of necrosis (Fig. 2-4).
Positronemission tomographyscan demonstrating SUV max of the lesion 14.62.
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F5
Positronemission tomography (PET) scan was suggestive of metabolically active lesion seen at L1 and L2 vertebra (Fig. 5).
Metaiodobenzylguanidine (MIBG) scan showing MIBG avid lesion near lumbar vertebra.
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F6
Scintigraphic evidence of metaiodobenzylguanidine (MIBG) avid mass in upper abdomen suggesting paraganglioma was found on iodine-123-MIBG scan(Fig. 6).
Posterior pedicular screw instrumentation.
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F7
Pedicular screw instrumentation (except at L1) and fusion were performed from D11 to L3 (Fig. 7).
Tumor mass being isolated.
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F8
In the second stage, the patient underwent excision of tumor mass with L1 corpectomy and anterior reconstruction with an expandable titanium cage and tricortical onlay graft by a retroperitoneal approach in the right lateral position (Fig. 8-10).
Reconstruction with expandable titanium cage.
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F9
In the second stage, the patient underwent excision of tumor mass with L1 corpectomy and anterior reconstruction with an expandable titanium cage and tricortical onlay graft by a retroperitoneal approach in the right lateral position (Fig. 8-10).
Final post-operative radiograph showing instrumentation and tricortical strut graft.
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F10
In the second stage, the patient underwent excision of tumor mass with L1 corpectomy and anterior reconstruction with an expandable titanium cage and tricortical onlay graft by a retroperitoneal approach in the right lateral position (Fig. 8-10).