PMC5525316_01
Sagittal MR image of the thoracic spine. Left: T1-weighted image. The tumor represents as a hypointense mass infiltrating the spine with spinal canal penetration. Right: T1-weighted, contrast enhanced image. Inhomogeneous gadolinium distribution.
IPRS-06-11-g-001.jpg
PMC5525316_01_IPRS-06-11-g-001.jpg
F1
MRI studies revealed a solid mass of 16x14x12 cm in the inferior posterior mediastinum on the left side with infiltration of Th9 and Th10 vertebral body and spinal canal infiltration with myelon compression (Figure 1 (Fig. 1), Figure 2 (Fig. 2)).
T1-weighted, contrast enhanced transverse MR image of the thoracic spine. Inhomogeneous gadolinium distribution. Solid mass in the posterior inferior mediastinum with spinal canal infiltration and myelon compression.
IPRS-06-11-g-002.jpg
PMC5525316_01_IPRS-06-11-g-002.jpg
F2
MRI studies revealed a solid mass of 16x14x12 cm in the inferior posterior mediastinum on the left side with infiltration of Th9 and Th10 vertebral body and spinal canal infiltration with myelon compression (Figure 1 (Fig. 1), Figure 2 (Fig. 2)).
Posterior long segment stabilization. Left: To decrease length of incision and muscle trauma, the cranial and caudal screws were placed in a percutaneous fashion. Right: Complete resection of the posterior bony elements of Th9 and 10, with tumor debulking and spinal canal clearance. The spinal nerves T9 and T10 were cut bilaterally.
IPRS-06-11-g-003.jpg
PMC5525316_01_IPRS-06-11-g-003.jpg
F3
Long segment stabilization was performed three levels above and three levels below (Figure 3 (Fig. 3)).
Anterior approach: Thoracolumbophrenotomy with en-bloc resection
IPRS-06-11-g-004.jpg
PMC5525316_01_IPRS-06-11-g-004.jpg
F4
After a few days of recovery the anterior procedure followed (Figure 4 (Fig. 4)).
Postoperative X-ray (a.p. and lateral view). Posterior long segment pedicle screw stabilization and anterior reconstruction via expandable cage.
IPRS-06-11-g-005.jpg
PMC5525316_01_IPRS-06-11-g-005.jpg
F5
TH9 and Th10 vertebral body as well as 2 level cage reconstruction of the anterior column was performed (Figure 5 (Fig. 5), Figure 6 (Fig. 6)). The patient recovered quite well after surgery: no problems of wound healing, no new neurological deficits, sensory deficit improved.
Mononuclear tumor cells with a mix of giant cells, spindle cells and round shaped cells. Hyperchromatic nuclei, partly pale and deeply eosinophilic cytoplasm.
IPRS-06-11-g-006.jpg
PMC5525316_01_IPRS-06-11-g-006.jpg
F6
TH9 and Th10 vertebral body as well as 2 level cage reconstruction of the anterior column was performed (Figure 5 (Fig. 5), Figure 6 (Fig. 6)). The patient recovered quite well after surgery: no problems of wound healing, no new neurological deficits, sensory deficit improved.