PMC8516554_01
(a) AP spine radiograph showing thoracic levoscoliosis with a calcified lesion projecting from the right posterior aspect of the midthoracic rib segments extending into the soft tissues. (b) Sagittal spine radiograph further demonstrating osseous projection from the midthoracic posterior rib segments.
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Plain films of the thoracic spine demonstrated levoscoliosis and an additional osseous projection from the right posterior aspect of the midthoracic rib segment (Figure 1).
(a) Sagittal T2-weighted MR image showing multilobulated, partially cystic, trans-spatial heterogenous mass extending cranially to T3 and caudally to T10 with soft tissue extension anteriorly into the dorsal aspect of the intrathoracic cavity. (b, c) Axial T2-weight MR image further demonstrating the mass centered at T5-6 paravertebral space extending anteriorly into the dorsal aspect of the intrathoracic cavity, into the right dorsal paraspinal soft tissue/musculature, and into the spinal canal with severe displacement of the cord and resultant spinal stenosis.
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Magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine revealed a multilobulated, partially cystic, calcified, heterogenous mass centered at the right (T5-T6) paravertebral space extending anteriorly into the dorsal aspect of the intrathoracic cavity (Figure 2(a)), right dorsal/posterior paraspinal soft tissues/musculature (Figure 2(b)), and spinal canal, resulting in severe displacement of the spinal cord, spinal stenosis and bilateral foraminal stenosis (Figure 2(c)).
Intraoperative photograph of the resected tumor.
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The final pathological diagnosis was consistent with a mature teratoma (Figures 3 and 4).
Microscopic review of both excisional biopsy and surgical resection showed similar histologic features comprised of myriad tissue types including bone, cartilage, and marrow elements (a); neuroglial tissue (b) with conspicuous, mature neurons (star), skin with surrounding supporting sebaceous glands (c); and respiratory tract epithelium admixed with serous and mucous glands (d). (a-d) Stained with hematoxylin and eosin and captured at 100x.
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The final pathological diagnosis was consistent with a mature teratoma (Figures 3 and 4).
(a, b) Postoperative AP spine and sagittal radiographs with no evidence of residual tumor or further progression of scoliosis.
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He returned for a follow-up visit at 1.5 weeks in a thoracic-lumbar-sacral orthosis (TLSO) brace and received full-length plain radiographs (Figure 5).