PMC9504096_01
Arterial (left) and portal (right) phase on contrast-enhanced CT show a heterogeneously enhancing mass (arrows) in the left posterior paravertebral region of thoracic spine, centered on muscle group.
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F1
Contrast-enhanced computed tomography (CT) revealed a heterogeneously enhancing mass, located in the left posterior paraspinal soft tissue (Figure 1).
Contrast-enhanced thoracic spine MRI with sagittal (A, B) and axial (C, D) planes shows a well-defined 9.0 cm sized mass between the left erector spinae and lower part of trapezius muscle. This mass shows T1 isointensity (C), T2 hyperinensity (A, D), and intense contrast enhancement suggesting myxoid component (B), intralesional linear fibrotic component, and subfascial location with tail sign (arrow).
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F2
Magnetic resonance imaging (MRI) showed a well-defined 9.0cm mass between the left erector spinae abutting the trapezius muscle (Figure 2). T1 isointensity (Figure 2C), T2 hyperintensity (Figure 2A and 2D), intense contrast enhancement (Figure 2B), inner linear fibrotic component, and deep intermuscular location with tail sign. These imaging findings were consistent with the preprocedural working diagnosis of myxofibrosarcoma.
Ultrasonography shows heterogeneous hypoechoic mass with hyperechoic septum in the intermuscular space between erector spinae and trapezius muscles. Ultrasonography guided biopsy was performed with semi-automated co-axial needle. The specimen notch (arrowheads) located in solid enhancing portion based on MRI.
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F3
Ultrasonography guided biopsy (Figure 3) was performed and pathologically confirmed extraabdominal DF.