PMC6556238_01
Magnetic resonance images (MRIs) and computed tomography scans (CTs) acquired at the time of acute onset of quadriparesis (a-f) and MRIs acquired 2 years earlier the quadriparesis (g, h): (a) sagittal T1WI, (b) axial T1WI, (c) sagittal T2WI, (d) axial T2WI, (e) sagittal CT, (f) axial CT, (g) sagittal T2WI, and (h) axial T2WI. Images at the onset shows a mass in the spinal canal at C4-5 on the right that is compressing the spinal cord. CT indicates that the mass did not contain osseous tissue. On the other hand, MRIs acquired 2 years earlier to investigate neck pain show that the tumor was present at that time but was not large or compressing the spinal cord.
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Emergent magnetic resonance imaging (MRI) revealed an epidural mass in the right ligamentum flavum at the C4-C5 level (Figures 1(a)-1(d)). Computed tomography (CT) scanning confirmed that there was no ossification in the mass (Figures 1(e) and 1(f)). However, cervical MRI scan that had been acquired 2 years earlier to investigate neck pain (Figures 1(g) and 1(h)) revealed that the tumor was present at that time but was smaller and not compressing the spinal cord.
(a, b) Macroscopic features of the tumor specimen with the cervical lamina (the smallest division of the scale is 1 mm). (c) Histological findings from the resected tumor revealed cartilaginous tissue with no atypical cells (hematoxylin-eosin staining).
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We removed the mass en bloc along with the right C4 and C5 lamina (Figure 2). The mass was 10 mm x 10 mm in size, and there was an appearance of cartilaginous tissue rather than a hematoma (Figures 2(a) and 2(b)). Hematoxylin-eosin staining showed cartilaginous tissue, there were no atypical cells, and the final diagnosis was chondromatous lesion (Figure 2(c)).
Postoperative MRIs confirm decompression of the cervical spinal cord. (a) Sagittal T2WI. (b) Axial T2WI.
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No recurrence was observed on follow-up MRI (Figure 3).