PMC9307392_01
Diffuse cutaneous nodules and cafe-au-lait spots.
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In general, the patient is a young slim man with numerous skin dimples (Figure 1) ranging from a few millimeters to about 2-3 cm diffused all over his skin.
Bilateral symmetrical C2 GN- axial T2WI at C1-C2.
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Sagittal T2WI showing expanded intervertebral foramina mostly at C1-C2 level (a) and dorsal intradural part of bilateral C2 ganlion GN, compressing spinal cord and causing signal change at highest cervical spinal cord segments.
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Sagittal-axial T2WI cross view of C4-C5 level showing bilateral symmetrical intradural ventrolateral C4 GN, compressing spinal cord.
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Sagittal spiral CT scan of cervical spine, showing C3-C4 partial fusion (a) and expanded intervertebral foramina mostly at C1-C2 level (b).
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Sagittal-axial cross-view of postoperative T2WI of C1-C2 level showing dorsal CSF collection (a), hemovaccum tube (b), Gelfoam covering dura (c), and no remnant of bilateral C1-C2 GNs.
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Postoperative early cervical MRI was performed to investigate tumor remnants and spinal cord release reported by radiologist as follows (Figures 6 and 7). "Posterior element of C1-C2-C3 and C4 is not seen, due to previous resection.
Sagittal-axial cross-view of postoperative T2WI of C4-C5 level showing spinal cord decompression and no remnant of bilateral intradural C4-C5 GNs.
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Postoperative early cervical MRI was performed to investigate tumor remnants and spinal cord release reported by radiologist as follows (Figures 6 and 7). "Posterior element of C1-C2-C3 and C4 is not seen, due to previous resection.
Histopathology of the tumor. (a, b) Histopathological sections of the tumor show bipopulation of the tumor cells, sheet of spindle shape bland looking cells mixed with scattered large spherical ganglion cells (*). Neither necrosis nor mitosis is seen in the tumor (x100, x400, hematoxylin and eosin). (c) Immunohistochemical stain for S-100 shows diffuse, strong immunopositivity in both neuroma and ganglion cell component (*) (x100). (d) Immunohistochemical stain for chromogranin shows immunostaining in ganglion cell component (*) only (x100).
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Few eosinophilic granular bodies were seen, and no mitosis and necrosis were identified (Figure 8).