PMC6701286_01
(a, b) MRI of the cervical spine showed IDEM mass, with low intensity in the T2-weighted imaging and isointensity in the T1-weighted imaging at the C3-4 levels. (c, d) The marked enhancement of the mass and a dural tail sign after intravenous admission of Gd-DTPA.
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Following the intravenous administration of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA), an intradural extradural mass with a marked gadolinium enhancement and a dural tail sign were observed (Figure 1).
(a) Intraoperative situs of the intradural extramedullary spinal sarcoid lesion. (b) Sarcoid lesion removed by surgery.
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Of note, the appearance of the actual mass differed from that of a meningioma, as it had been preoperatively suspected to be based on the MRI findings (Figure 2).
The resected lesion is composed of multiple noncaseating granulomas with fibrosis. Multinucleated giant cells are observed (H&E, original magnification).
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While most of the granulomas did not show necrosis, there were some small necrotic foci at the center of the granulomas (Figure 3).
(a, b) MRI of the cervical spine performed four years after the surgery showed no recurrence, and the dural tail sign had disappeared.
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No abnormalities on MRI were noted at that time (Figure 4).