PMC6911671_01
Preoperative magnetic resonance imaging (MRI) with gadolinium showed an expansile intramedullary tumor of thoracic cord and conus medullaris with irregular heterogeneous enhancement and some cystic changes on sagittal (a and b) and axial (c) views in a 9-year-old patient with severe thoracolumbar scoliosis (d). After surgical treatment, 2 years follow-up MRI reveals an evidence of minimal cord herniation toward laminectomy sites and intramedullary cystic changes (sagittal T2 sequence), (e) with minimal enhancement on sagittal (f) and axial (g) views.
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F1
The holospinal magnetic resonance (MR) revealed an intraaxial/intramedullary ill-defined expansile lesion with heterogeneous enhancement extending from the cervicothoracic junction to conus medullaris [Figure 1]. Two years later, the patient improvement has continued and the follow-up MR showed no further progression [Figure 1].
This shows histopathology of resected tumor. We could see hypocellular glial tumor, in which monomorphic piloid tumor cells are dispersed in a myxoid matrix (Hematoxylin and Eosin stain, x100) (a). Furthermore, tendency of piloid perivascular cells to form a rosette-like structure without any Rosenthal fiber could be seen (Hematoxylin and Eosin stain, x400, b). (c) Reveals a strong immunoreactivity of the tumor cells for glial fibrillary acidic protein (GFAP immunostaining, x100, c).
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F2
As the histopathological exam showed a PMA, adjuvant therapy included spinal radiation [Figure 2].