PMC4508742_01
Magnetic resonance (MR) imaging of the thoracic spine showing a partially cystic intramedullary mass, which is hyperintense on T1-weighted image (A), hypointense on T2-weighted image (B), and enhances homogenously with gadolinium diethylpentoic acid (C). Contrast-enhanced T1-weighted axial image shows displacement of the normal parenchyma of the cord ventrally (D).
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F1
It enhanced homogeneously with gadolinium diethylpentoic acid (Fig. 1).
Intraoperative photograph shows pigmentations in the dura and arachnoid. Black tumor is seen on the posterior surface of the cord.
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F2
The skin over the lesion was normal, but the laminae and dura had multiple pigmentations. The black-colored tumor was observed on the dorsal surface of the cord, with a soft pial part that was easily peeled off and a elastic hard intramedullary part that was adherent to the pia and richly vascularized (Fig. 2). The tumor was totally removed through a midline myelotomy.
The T2-weighted magnetic resonance (MR) image of the abdomen shows a round mass (arrow) in the retroperitoneum.
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F3
T2-weighted MR images (Fig. 3) and manifested a high uptake of 2-[(18) F]-fluoro-2-deoxy-D-glucose (FDG) on positron emission tomography (PET). The pigmented tumor in the retroperitoneal adipose tissue was totally removed through a conventional laparotomy without adverse consequences.
Magnetic resonance (MR) imaging of the thoracic spine 4 years after surgery. T1-weighted images without contrast (A) and with contrast (B) show no tumor recurrence.
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F4
Thoracic spine MR imaging and whole-body FDG-PET scan reveal no tumor recurrence (Fig. 4).
Hematoxylin and eosin-stained section of the intramedullary tumor shows proliferation of cells with fibrous tissue background (A). The tumor infiltrates into the spinal cord parenchyme (B).
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F5
The tumor cells infiltrated into the perivascular space and spinal cord parenchyma (Fig. 5).