PMC10187594_01
Computed tomography scan sagittal images (a) soft-tissue window and (b) bone window show destructive lesion in T12 vertebral body with Grade 3 compression fracture and extra osseous soft-tissue component extending into the spinal canal (red arrows)
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F1
T12 vertebral body with Grade 3 compression fracture and associated soft tissue component extending into spinal canal [Figure 1]. The patient was called to the emergency department, and a detailed medical history and physical examination were performed.
Sagittal magnetic resonance images through thoracolumbar spine show Grade 3 pathological compression fracture of T12 vertebral body with altered marrow signals; intermediate on T2-weighted imaging (WI) (a), hyperintense on Short Tau Inversion recovery sequence (b) and hypointense on T1WI (c). Post-contrast T1WI (d) shows enhancing soft tissue component extending posteriorly within spinal canal deep to posterior longitudinal ligament causing effacement of the anterior thecal sac and compression of the conus medullaris (red arrow). Enhancing soft-tissue component is noted anteriorly as well beneath anterior longitudinal ligament (blue arrow)
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F2
No edema seen within the conus medullaris [Figure 2].
Contrast-enhanced computed tomography through abdomen axial section (a) shows a hypodense lesion in the body of the pancreas. This lesion was showing a heterogeneous signal on T2WI (b) and TIWI (c) and peripheral rim enhancement on post-contrast TIWI (d) in previously performed magnetic resonance imaging spine (shown by the blue arrow)
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F3
Furthermore, CT abdomen and pelvis with contrast was performed that showed a hypodense lesion measuring 13 mm x 9 mm in the body of pancreas on the background of normal pancreatic parenchyma without any surrounding fat arborization [Figure 3].
(a and b) show images of computed tomography-guided bone biopsy performed for T12 vertebral body lesion. A 10-G MADISON bone biopsy system was parked over the right pedicle of the T12 vertebra. Two cores were obtained from the T12 vertebral body using the transpedicle approach
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F4
A CT guided bone biopsy was performed [Figure 4] and histopathology confirmed metastatic MC.