PMC8645484_01
MRI of the thoracic spine. (a) Sagittal T1 and (b) sagittal T2-weighted image shows isointense extradural mass (yellow arrow) in thoracic spinal canal lying from T2 until T4 levels. (c) Axial T2-weighted imaging shows severe thoracic canal narrowing due to compression by the mass (yellow arrow).
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F1
A whole spine MRI revealed a posterior isointense soft-tissue mass, measuring 69.5 x 16 mm at the T2-T4 levels that markedly compressed the cord [Figure 1].
MRI of the thoracic spine. (a) Sagittal T1 and (b) axial T1 MRI after injection of contrast agent show strong homogenous enhancing mass (yellow arrow).
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F2
It was strongly homogenously enhanced with contrast [Figure 2].
(a) Epidural tumor (b) after total resection, it showed intact duramater.
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F3
T2-T4 laminectomy for posterior extradural tumor resection followed by pedicle screw stabilization. The lesion had a well-defined border and was removed in a piecemeal fashion; the dura remained intact [Figure 3].
Brisk mitotic activity and the cellular area consists of spindle nuclei arranged in palisading pattern on x40 zoom (a) and x100 zoom (b).
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F4
Histopathology revealed brisk mitotic activity with the cellular area consisting of spindle nuclei arranged in a palisading pattern [Figure 4].
Pattern of perivascular hypercellularity and slight intraluminal herniation on x40 zoom (a) and x100 zoom (b).
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F5
There was perivascular hypercellularity and slight intraluminal herniation along with well-delineated geographical necrosis with some areas with enlarged round nuclei [Figures 5-7].
Pattern of perivascular hypercellularity and slight intraluminal herniation on x40 zoom (a) and x100 zoom (b).
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F6
There was perivascular hypercellularity and slight intraluminal herniation along with well-delineated geographical necrosis with some areas with enlarged round nuclei [Figures 5-7].
Well-delineated geographical necrosis on x40 zoom (a) and x100 zoom (b).
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F7
There was perivascular hypercellularity and slight intraluminal herniation along with well-delineated geographical necrosis with some areas with enlarged round nuclei [Figures 5-7].
Immunohistochemistry staining showed positivity for S-100 (a), CD-99 (b), and Ki67 (c) on x40 zoom.
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F8
Immunohistochemistry staining was positive for S100, CD99, and Ki67 [Figure 8], supporting the final diagnosis of thoracic spinal MPNST.
Sagittal T1 (a) and T2 (b) sagittal T2-weighted image thoracic MRI showed spinal cord swelling on the T2-T3-T4 levels.
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F9
Six months later, after completion of radiotherapy, the thoracic spine MRI without contrast demonstrated cord swelling at the T2-T3-T4 levels [Figure 9].