PMC8053463_01
Sagittal (a) and axial (b) preoperative MRI showing epidural compression and circumferential vertebral involvement.
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T11 level due to the SDC (i.e., Bilsky Grade 2 epidural compression) [Figures 1a and b]. The patient underwent biopsy/surgical decompression/resection of the tumor utilizing a left T11 laminectomy.
Intraoperative image (a) displaying the circumferential decompression and vertebral fixation with carbon fiber system. Postoperative sagittal (b) and axial (c) CT scan showing the accuracy of fixation system placement. Postoperative MRI image (d) demonstrating the epidural decompression and the absence of local disease recurrence.
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T11 pedicle was removed, followed by partial T11 corpectomy and the posterior application of two carbon rods from T10 to T12 [Figure 2a]. The postoperative spinal CT scan confirmed that the fixation system was accurately placed and that the spinal cord was sufficiently decompressed [Figures 2b and  c]. One-month post-operatively, the MRI confirmed adequate epidural decompression without tumor recurrence [Figure 2d].
Histological findings after vertebral lesion resection. H and E image (a: 100X, b: 200X) shows a bone infiltrating metastatic carcinoma with duct structures and comedonecrosis. Neoplastic cells were mildly pleomorphic with an eosinophilic cytoplasm and features consistent with apocrine differentiation. Immunohistochemical stainings showed a diffuse positivity for GCDFP15 (c) and androgen receptor (d), while cytokeratins 8/18 were focally positive (e).
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Immunohistochemical stainings for gross cystic disease fluid protein-15 (GCDFP15) and androgen receptor (e.g., for the T11 biopsy material) were diffusely positive; while cytokeratins 8/18 were focally positive [Figures 3a, b, c, d and e], all remaining consistent with the diagnosis of a SDC.