PMC4533341_01
A: Preoperative T1-weighted axial magnetic resonance imaging (MRI) with gadolinium reveals homogenous enhancement of the midline clival lesion. B: Preoperative T1-weighted sagittal MRI with gadolinium shows the lesion bending the brain stem. C: Preoperative T2-weighted axial MRI demonstrates no remarkable perifocal edema.
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F1
T1-weighted images and hyperintense on T2-weighted images. T1-weighted MRI with gadolinium revealed homogenous enhancement of the lesion that displaced the brain stem posteriorly (Fig. 1A, B). No remarkable perifocal edema was detected on T2-weighted images (Fig. 1C).
A: Preoperative T1-weighted sagittal magnetic resonance imaging (MRI) shows an isointense lesion at C1/C2 level. B: Preoperative T2-weighted sagittal MRI shows a hyperintense lesion at C1/C2 level. C: Preoperative T1-weighted sagittal MRI with gadolinium reveals homogenous enhancement of the lesion. D: Preoperative T1-weighted axial MRI with gadolinium demonstrates an intradural extramedullary lesion that displaced the spinal cord anterioly. E: T1-weighted sagittal MRI shows isointense lesions at Th2 and Th3 levels. F: T1-weighted sagittal MRI shows an isointense lesion at Th12 level. G: T1-weighted axial MRI demonstrates an intradural extramedullary lesion at Th2 level.
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F2
T1-weighted images and hyperintense on T2-weighted images (Fig. 2A, B). T1-weighted MRI with gadolinium revealed homogenous enhancement of the lesion (Fig. 2C, D). Further, thoracic and lumbar MRI revealed small asymptomatic multiple mass lesions (Fig. 2E-G).
A: Intraoperative photograph demonstrates an intradural extramedullay tumor. C1-2 laminectomy is performed. The mass lesion compresses spinal cord. The mass was totally intradural and not to arise from the dura matter. B: The tumor is totally extirpated.
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F3
The patient underwent laminectomy at C1-C2 along with total removal of the tumor (Fig. 3).
A, B: Postoperative T1-weighted sagittal (A) and axial (B) magnetic resonance imaging (MRI) with gadolinium reveal no enhanced mass lesion. Axial MRI also shows no spinal cord compression.
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F4
A postoperative MRI demonstrated a total removal of the tumor (Fig. 4).
A, B: Photomicrograph of the spinal tumor consists of sheets of physaliphorous cells (A, x20, hematoxylin eosin stain) and the Ki-67 labelling index was 3.5%. B: The histological diagnosis is chordoma.
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F5
Histopathological examination confirmed the diagnosis of a chordoma, and the Ki-67 labeling index was 3.5% (Fig. 5).
A, B: Postoperative T1-weighted sagittal (A) and axial (B) magnetic resonance imaging (MRI) with gadolinium reveal no enhanced mass lesion. The intracranial tumor was subtotally removed.
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F6
One month after the cervical surgery, the intracranial tumor was subtotally removed in a surgery via the right subtemporal approach (Fig. 6).