PMC3325748_01
A) Sagittal T1 magnetic resonance imaging without gadolinium contrast; B) Sagittal T2 magnetic resonance imaging.
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F1
T11 vertebral body within the spinal canal (Figures 1-3).
Axial T2 magnetic resonance imaging fast spin echo at A) T11 (cephalad); B) T11 (middle); C) T11 (caudal).
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F2
T11 vertebral body within the spinal canal (Figures 1-3).
A) Sagittal T1 magnetic resonance imaging with gadolinium contrast; B) axial T1 magnetic resonance imaging with gadolinium contrast at T11.
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F3
T11 vertebral body within the spinal canal (Figures 1-3).
Intra-operative photograph.
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F4
The dura was opened in the midline exposing an intramedullary lesion reminiscent of a cavernous malformation (Figure 4).
Gross specimen.
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F5
The lesion was carefully resected from the surrounding cord and sent whole for pathological analysis (Figure 5).
Hematoxylin and eosin stain.
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F6
Hematoxylin and eosin staining was performed and demonstrated a heavily pigmented spindle cell neoplasm suggestive of a melanotic schwannoma (Figure 6).
Melan-A stain.
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F7
Tumor cells stained with antibodies to melan-A (Figure 7).
Spindled cells, numerous late-stage melanosomes, predominantly stage IV); surrounded by a characteristic single continuous basal lamina.
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F8
Electron microscopy, in addition to intracellular late stage melanosomes, demonstrated the presence of a continuous pericellular basal lamina confirming the schwannian nature of the cells (Figure 8).
A) Sagittal T1 magnetic resonance imaging without gadolinium contrast (postoperative); B) sagittal T2 magnetic resonance imaging (post-operative).
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F9
A post-operative MRI performed three months after surgery revealed no evidence for residual or recurrent tumor (Figures 9A and 9B).