PMC5453863_01
Sagittal (B) T1-weighted (A), T2-weighted FrFSE (B) and T2-weighted FrFSE fat sat (C) magnetic resonance images revealing a large omogeneously hyperintense intradural lesion (yellow arrow) extending from L1 to L2, with enhancement after gadolinium and flow voids cranial to the mass indicative of venous congestion or high vascularity of the tumor.
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Emergent MRI (Magnetic Resonance Imaging) demonstrated a large intradural well encapsulated tumor extending from L1 to L2 compressing the cauda equine, measured about 4 cm in cranio-caudal diameter, heterogeneously enhancing after gadolinium injection with serpentine flow-voids in the subarachnoid space cranial to the tumor and with FrFSE (Fast Relaxation Fast Spin Echo) MR images showing uniform hyperintensity suggestive of an intralesional and intradural bleed (Figs. 1 and 2a-c ).
Axial T1 (A) and T2-weighted (B) and coronal T1-weighted (C) images showing a large lesion (yellow arrow) taking up the vast majority of the cross-sectional area at L1-L2 level, obscuring the visibility of the cauda equina. Photograph of the hemorrhagic paraganglioma (4 x 2 cm) after excision en bloc (D). One year post-operative, sagittal T1-weighted image after gadolinim (E) demonstring no residual or recurrent contrast enhancing tumor.
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Emergent MRI (Magnetic Resonance Imaging) demonstrated a large intradural well encapsulated tumor extending from L1 to L2 compressing the cauda equine, measured about 4 cm in cranio-caudal diameter, heterogeneously enhancing after gadolinium injection with serpentine flow-voids in the subarachnoid space cranial to the tumor and with FrFSE (Fast Relaxation Fast Spin Echo) MR images showing uniform hyperintensity suggestive of an intralesional and intradural bleed (Figs. 1 and 2a-c ). After coagulation and cutting of this vein, the tumor was freed from its superior attachment and then removed en bloc (Fig. 2d). At one year post-operative MRI showed no evidence of tumor recurrence (Fig. 2e).