PMC5597815_01
A,B) Anteroposterior and lateral radiograph showed a discrete loss of height and asymmetry of the T11 vertebral body and as well as cortical expansion, effacement of the left pedicle and sclerosis. C-D) CT showed an expanded lobular lytic lesion boundary, partial sclerotic borders of the T11 vertebral body and thinning with anterior cortical and posterior wall rupture.
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In the X-Ray study (Fig. 1), an injury at the T11 vertebral body level with discrete loss of the T11 vertebral body height and asymmetry of the vertebral body was observed, in addition to cortical expansion, effacement of the left pedicle and sclerosis. CT showed an expanded lobular lytic lesion boundary, partial sclerotic borders of the T11 vertebral body and thinning with anterior cortical and posterior wall rupture (Fig. 1).
MR showed a solitary lesion in T11 while diffuse hypointense on T1-weighted and heterogeneously hyperintense on T2-weighted were observed. Furthermore, a small mass of pre-vertebral soft tissue and anterior epidural and contrast enhancement were detected.
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By MR, a solitary lesion in T11, diffuse hypointense on T1-weighted and heterogeneous hyperintense on T2-weighted were observed (Fig. 2).
H/E staining. Spindle cell proliferation: highly cellular, cigar-shaped nuclei with marked atypia and pleomorphism, without mitosis or necrosis and with areas of lower cellularity and hyalinized foci.
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There were no mitotic images or necrosis (Fig. 3).
Inmunostaining: A) Smooth muscle actin: diffuse positivity B) Caldesmon: focal positivity C-D) Desmin and CD34: negative.
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Immunostaining showed intense and diffuse positivity for smooth muscle actin (1A4) with focal positivity for caldesmon; S100, desmin, actin (HHF35), CKAE1/AE3 and CD34 were negative (Fig. 4).
After 60 months of follow-up, an anteroposterior and lateral radiograph showing adequate coronal and sagittal balance (A, B). In the CT-body (C-F) and MR images studies (G, H), a free medullary canal without changes of local recurrence in the adjacent vertebral bodies, solid fusion and no distant lesions suggesting a primary lesion were observed.
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In the MR and CT-body image studies, a free medullary canal without changes of local recurrence in the adjacent vertebral bodies, solid fusion and no distant lesions suggesting a primary lesion were observed (Fig. 5).