PMC9609879_01
(a) Sagittal and (b) coronal T1-weighted image demonstrating the posterolateral hyperintense lesion infiltrating the spinal cord located between obex and the posterior arch of C2 (red arrow) with associated syringomyelia extending from the tumor to C6 (white arrow).
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F1
The cervical MRI with gadolinium showed an oval mass in the intradural space at the obex extending to the superior margin of C2 markedly enhancing following the administration of contrast and associated with syringomyelia extending from the obex to C6 [Figure 1].
(a and b) Intraoperative images showing the subdural, intra/extra-axial lesion localization, which was completely removed after spinal cord exposure, following a complete C1 laminectomy and suboccipital craniotomy.
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F2
Intraoperatively, the lesion was red and elastic in consistency, richly vascularized, and extended to the central canal of the spinal cord [Figure 2].
Follow-up MRI showing gross total removal of the HBL and reduction of the syrinx.
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F3
Further, the MRI confirmed no tumor recurrence and a significant reduction of the accompanying syringomyelia [Figure 3].
(a) (x 40) and (b) (x 100) pathological examination with hematoxylin and eosin staining revealed large, stromal cells rich in lipids, and intertwined with thin-walled capillaries. C Immunohistochemical staining with inhibin A showing marked positivity of the neoplastic cells.
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F4
Immunohistochemical staining revealed the presence of stromal cells positive for inhibin A and NSE while immunonegative for CD10 and EMA [Figure 4].