PMC5233733_01
Preoperative computed tomography of S1 and L1 reveals bone destruction and vertebral abnormalities. a L1 Vertebral lesions and vertebral invasion. b S1 Vertebral lesions and vertebral invasion. Red arrows indicate location and extent of the lesions
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Fig1
L1 and S1 (Fig. 1). Lumbar vertebra magnetic resonance imaging (MRI; Fig. 2) also revealed that the left half of the L1 vertebral body had been destroyed and that the S1 lesion extended into the soft tissues.
Preoperative magnetic resonance imaging of L1 and S1-S2 reveals bone destruction and vertebral abnormalities. Red arrows indicate L1 (upper arrow) and S1-S2 (lower arrow) lesions in MRI
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Fig2
L1 and S1 (Fig. 1). Lumbar vertebra magnetic resonance imaging (MRI; Fig. 2) also revealed that the left half of the L1 vertebral body had been destroyed and that the S1 lesion extended into the soft tissues.
A preoperative whole-body bone scan reveals abnormal bone densities at L1 and S1-S2, which indicated metastatic tumors. Red arrows show extent of invasion of lesions in whole-body bone scan
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Fig3
A whole-body bone scan (Fig. 3) revealed generally clear results, although the L1 and S1-S2 vertebrae exhibited abnormal bone densities, which indicated the possibility of bone tumor.
Postoperative pathology reveals epithelioid cells and multinucleated giant cell granuloma formation, with significant caseous necrosis, granuloma, and a diffuse oval body with refraction around the crassicarpa membrane. Positive periodic acid-Schiff (PAS) and periodic acid-silver methenamine (PASM) results indicate a fungal infection. a PASM is positive. b pathological results: fungal infection. c positive periodic acid-schiff (PAS(+))
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Fig4
The postoperative pathology report identified inflammatory changes at L1 and S1, which indicated a fungal infection (Fig. 4).
Computed tomography at a 3 months and b 9 months reveals no symptoms of recurrence and no changes in the lesions. Red arrows show improvement of lesions at 3-month and 9-month follow-up
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Fig5
The patient also did not exhibit any symptoms of recurrence or abnormal imaging findings at the 9-month follow-up (Fig. 5).