PMC9939244_01
Sagittal magnetic resonance imaging findings.. (A) Preoperative T1 image with contrast. (B) Preoperative T2 image. (C) Post-biopsy and drainage T1 image with contrast. (D) Post-biopsy and drainage T2 image. (E) Post-resection T1 image with contrast. (F) Post-resection T2 image.
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FIG1
C7 pedicle. T2 central hypodensity extended beyond the cyst to the level of the T1-2 disc space, concerning for either infiltrative tumor, pre-syrinx, or syrinx with surrounding edema (Figures 1A, 1B). Contrasted T1 scans showed an irregular enhancement pattern along the superior tumoral border down to the C3 pedicle. Postoperative MRI revealed a well-demarcated more homogenously enhancing mass extending from the foramen magnum to C2 in addition to a caudal polar cyst with a resolution of pre-syrinx edema (Figures 1C, 1D). Post-resection, no residual enhancement was seen, and the hemosiderin cap was seen centrally adjacent to the C2-3 disc space (Figures 1E, 1F).
Intraoperative image.. Intraoperative photograph at second-stage resection. White tubing in the center of the canal is the syringo-subarachnoid shunt tube. Normal spinal cord and dorsal columns are seen as white linear structures along either side of the dark pink mass below the pial surface, which is ependymoma.
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FIG2
She underwent a C1 laminectomy for open biopsy and cysto-subarachnoid shunt, which can be seen in the second-stage intraoperative photograph in Figure 2. As seen in Figure 2, the tumor borders appear well-defined.