PMC5778725_01
T1-weighted (a) and T2-weighted (b) sagittal magnetic resonance images. An intradural spinal tumor existed at the level of L1 vertebral body. The tumor appeared isointense on both T1-weighted and T2-weighted MR images. Peritumoral cyst was seen at the cranial and caudal sides
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F1
T1-weighted (T1) and T2-weighted (T2) MR images [Figure 1]. The T2 MR study showed a clear margin of the tumor and demonstrated both cranial and caudal peritumoral cysts without syrinx formation [Figure 2].
T2-weighted axial magnetic resonance images, T12-L1 intervertebral disc level (a) and L1 vertebral body level (b). Peritumoral cyst was evident
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F2
T1-weighted (T1) and T2-weighted (T2) MR images [Figure 1]. The T2 MR study showed a clear margin of the tumor and demonstrated both cranial and caudal peritumoral cysts without syrinx formation [Figure 2].
T1 image with gadorinium MR image, sagittal view (a) and axial views T12-L1 intervertebral disc level (b) and L1 vertebral body level (c). Homogeneously enhanced and lobulated tumor was clearly seen
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F3
Gadolinium-enhanced T1-weighted MR revealed homogeneously enhanced and lobulated tumor [Figure 3].
Preoperative selective spinal angiogram from left T10 artery. Abnormal vessels with tumor stein was observed
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F4
Preoperatively, a selective spinal angiogram confirmed the high vascularity of the tumor with a predominant supply from anterior spinal artery (e.g., arising from left T10 artery) [Figure 4].
(a) Intraoperative view when opening the dura matter. A reddish tumor associated with peritumoral cysts at both cranial and caudal sides was found. (b) The tumor arose from the film terminale
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F5
Under the operative microscope, the dura and arachnoid were opened, revealing a reddish tumor originating from the conus accompanied by cranial and caudal peritumoral cysts [Figure 5a and b].
Intraoperative indocyanine green (ICG) videoangiography showing the tortuous feeding arteries from the both poles and the draining vein along the film terminale
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F6
Intraoperative indocyanine green (ICG) videoangiography showed the tortuous feeding arteries from the both poles and the draining vein along the film terminale [Figure 6].
Histopathological findings of the tumor (HE stain). The tumor was composed of vacuolated stromal cells and small nucleus in a rich capillary network with several enlarged vessels
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F7
The histological examination of the tumor was consistent with a hemangioblastoma; it revealed stromal cells with vacuolated cytoplasm and small nuclei in a rich capillary network with several enlarged vessels; there were no mitotic elements [Figure 7].