PMC6334320_01
Thoracolumbar T2W1 MRI in the sagittal plane (a and b) and axial plane (c and d) at the tumor height. We can observe the growth of hyperintensity from T10 to L2 in (b) compared with the initial MRI taken (a). Tumor margins are marked with the arrows. Axial T2W1 images on the tumor edges are shown in (c) and (d); the tumor diameter and length have increased in the space of four months.
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An MRI was obtained, and a tumor mass in the intradural region level of T10-T12 was found (Figure 1). Another MRI was performed and showed that the mass had grown to lumbar vertebrae L2, accompanied with worsening of the neurological statuses and impaired sensibility, as well as defecating and urinating problems (Figure 1).
Intraoperative pictures: the exposure of the spine using a posterior approach. Durotomy was performed from thoracal T10 to lumbar L1. The intradural tumor mass can be seen in (a). Tumor was then exsanguinated and evacuated. The tumor specimens were covered in blood and rich in vessels (b). We can see the empty space in dura, which was previously filled with the tumor. Dura was then closed with polypropylene suture 6.0 (c and d). The pedicle screw and rod system was implanted only on the left side to strengthen the spine after laminectomy in four levels.
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The operation started by opening the lamina on T10-T12 levels, followed with laminectomy and hemostatic procedure to stop the bleeding, until the dura was exposed (Figure 2). The tumor mass was excised, and the surgical field was contaminated by blood from hematomas from tumor vessels (Figure 2). The tumor mass was fixed and transported for histopathology examination (Figure 2).