PMC8088479_01
(a and b) Sagittal T2-weighted MRI scans taken at the time of presentation show a slightly hyperintense heterogeneous mass at the level of T8-T9. (c and d) T1-weighted MRI scans taken after gadolinium administration show a hypointense mass with circumferential enhancement. Axial T1 (e) and T2 (f) images show an extramedullary intradural dumbbell-shaped mass.
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F1
T8-T9. To further characterize the spinal lesion, MRI imaging was obtained and confirmed the presence of a heterogeneous mass at the left T8 that was hyperintense on T2-weighted and hypointense on T1-weighted images [Figure 1].
Intraoperative view of the dark, dumbbell-shaped tumor with apparent hemorrhage within the dural sac near the left T8 spinal nerve.
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F2
A dark, dumbbell-shaped mass could be seen extending from the left spinal column grossly [Figure 2].
(a) Tumor is circumscribed with cells in fascicles and nests. (b) Fascicles and nests composed of plump spindle cells. (c) Adipose-like cells admixed with tumor cells. (d) Melanin pigment deposition in the tumor cells (hematoxylin-eosin, original magnifications x40 (a), x100 (b), x200 (c and d)).
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F3
Post-operative histological examination showed fascicles and nests of plump spindle cells, consistent with schwannoma [Figure 3]. Variable amounts of melanin were also seen within tumor cells [Figure 3], leading to further immunohistochemical staining.
(a) S100 expression in tumor cells. (b) SOX10 expression in tumor cells. (c) HMB-45 expression in tumor cells. (d) MART-1 expression in tumor cells (original magnification x100 (a through d)).
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F4
Tumor sections showed positive expression of S100, SOX10, HMB-45, and MART-1 [Figure 4], compatible with a diagnosis of MS.
Sagittal (a) and axial (b) T2-weighted MRI images taken 2 months after the removal of a spinal MS tumor.
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F5
Imaging did not show any local recurrence of the tumor [Figure 5].