PMC7509573_01
Magnetic resonance imaging of a 25-year-old man revealed an intradural extramedullary lesion at the T10 and T11 levels. The lesion shows hypointense in T1-weighted (a, b), isointense in T2-weighted (c, d) and heterogeneous in gadolinium enhancement (e, f) sagittal and axial magnetic resonance imaging of the thoracic spine. Arrows indicate the location of the lesion.
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Magnetic resonance imaging (MRI) showed an intradural extramedullary lesion with hypointense changes on T1 and isointense changes on T2 as well as heterogeneous gadolinium enhancement at the T10 and T11 levels (Figure 1).
Magnetic resonance imaging before myelography (a) and computed tomography after the myelography (b) shows the intradural mass rostrally migrated with approximately 10 mm discrepancy in the exact location compared to magnetic resonance imaging findings. Arrows indicate the location of the lesion. Each level of axial image on computed tomography shows the proximal (c, d), middle (e, f), and distal (g, h) levels of the tumor.
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CSF was drained, and the pain improved immediately. Computed tomography (CT) after myelography revealed a rostrally migrated intradural mass with an approximately 10 mm discrepancy in the exact location compared to MRI findings (Figure 2).
A well-capsulated, dark-reddish tumor was resected in an en bloc fashion (a). Histological images (b) showing Antoni A-positive areas composed of spindle cells with nuclear palisading (hematoxylin and eosin stain). No marked nuclear atypia, mitotic figures, or necrosis was seen. S-100 protein was strongly expressed (c).
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Surgical treatment the day after myelography achieved complete resection of the intradural extramedullary tumor, and a histological examination confirmed the diagnosis of schwannoma (Figure 3).
Magnetic resonance imaging one year after operation shows a completely resected and well-decompressed spinal cord.
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At 12 months after surgery (Figure 4), he was working as a physical education teacher despite having hyperreflexia in his lower limbs.