PMC4925911_01
MRI of the lumbar spine.. (A) A sagittal T1-weighted image which shows a hypointense signal, a fracture at the level of L2, and a prevertebral extension at the lower third of L1 and upper L3. Also seen is an anterior epidural component which contacts the L1-L2 disc and extends caudally, especially on the left side, a few millimeters from the L3 to L4 disc.. (B) A sagittal T2-weighted image showing a hyperintense signal of the bone marrow at the affected levels.. (C) A coronal T2-weighted image reveals paravertebral extension that appears predominantly on the left side of the tumor. The right paravertebral component extends from the L1 to L2 disk psoas and has a longitudinal diameter of 6.6 cm. The left paravertebral extends from the T12 to L1 disk to L3 to L4. The rest of the impact on the left psoas is appears to be due to a hematoma.. (D) An axial T2-weighted image.
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CT of the lumbar spine revealed a pathological fracture in L2 and that the prevertebral tumor extended into L1 and L3 (Fig. 1).
A coronal and an axial CT angiogram in which thrombi are seen in the yuxtrarrenal vena cava and the left renal vein.
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CT scans of the chest, abdomen, and pelvis confirmed no evidence of metastatic disease. CT angiography revealed a thrombus in the yuxtarenal vena cava and the left renal vein (Fig. 2).
An anteroposterior radiograph and profile of the postoperative lumbar spine.
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T10-T12, L4, and L5 was carried out with pedicle instrumentation and at the stackable boxes of T12 to L3 with a structural allograft (Fig. 3). Tumor growth in the epidural venous plexus was monitored during this final stage of surgery.
Optical microscopy images.. (A) Pleomorphic multivacuolated lipoblasts with hyperchromatic nuclei, and elongated cells, fusiforms (100 x hematoxylin and eosin stain). (B) Immunohistochemical studies which reveal a negative immunoexpression for cytokeratin (CAM 5.2, AE1/3), CD 34, specific active muscle, and S100
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Histological analysis tumor specimen showed that it had the features of a pleomorphic liposarcoma (Fig. 4, Fig. 5).