PMC3170827_01
(a) Lateral radiograph showing irregular osteolysis at the anterior part of C2. Magnetic resonance (MR) imaging ((b) T1-weighted and fat suppression sagittal image with gadolinium enhancement, (c) T2-weighted sagittal image) showing a mass lesion at C2, which has marked enhancement after intravenous injection of gadolinium-DTPA. (d), (e) Axial image of computed tomography (CT) at the level of C2 showing irregular osteolysis at the anterior part of C2 and thickening of the posterior pharyngeal wall. ((d) CT for radiation therapy planning, (e) CT postradiation therapy with intravenous injection of gadolinium-DTPA).
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fig1
The mass had marked and homogeneous enhancement after intravenous injection of gadolinium-DTPA (Figure 1).
(Images of left column (a, d, g), middle column (b, e, h), and right column (c, f, i) are postoperatively 1 week, 4 weeks, and 9 weeks, resp.) Lateral radiograph (a, b, c) and axial image of CT at the level of C2 (d) showing disappearance (a, c, d) or decrease (b) of the middle pharyngeal space surrounded by the thickened pharyngeal wall. Reconstructed sagittal CT 1 week postoperatively (g) showing the disappearance of the middle pharyngeal space, that 4 weeks postoperatively (h) shows improvement and that 9 weeks postoperatively (i) shows deterioration. T2-weighted sagittal MR imaging 9 weeks postoperatively (f) showing enlargement of the mass lesion at C2 compared to that at 4 weeks postoperatively (e).
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fig2
These findings did not improve well during the patient's postoperative course (Figure 2).