PMC7827366_01
Sagittal (a) and axial (b) T1-weighted magnetic resonance image (T1WI) showing an intramedullary exophytic C2-C3 tumor with homogeneous gadolinium enhancement. (c) T2-weighted images showing a hyperintense mass with associated spinal cord edema inferior to the lesion with signal void images in the upper cervical spine representing prominent vessels within the cerebrospinal fluid. (d and e) Feeding branches from both vertebral arteries were visualized on digital subtraction angiogram (black arrows in d), including a right lateral spinal artery (black arrow on e) descending from the right posteroinferior cerebellar artery (black arrow on e). Sagittal (f) and axial (g) contrast T1WI confirming complete tumor resection.
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F1
Digital subtraction angiogram (DSA) showed rich tumor vascularization with feeding branches from both of the vertebral arteries, including a right lateral spinal artery descending from the right posteroinferior cerebellar artery (PICA) [Figure 1a-e]. The immediate postoperative MR confirmed GTR [Figure 1f-g].
PMC7827366_02
Sagittal (a) and axial (b) T1-weighted magnetic resonance image (T1WI) showing an intramedullary exophytic C5-C7 tumor with homogeneous gadolinium enhancement. (c) Slight heterogeneous aspect on T2-weighted images (predominantly hypointense with alternating smaller hyperintense areas). Sagittal (d) and axial (e) T1WI indicating complete removal of the tumor.
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F2
The lesion was isointense on T1WI, heterogeneous on T2WI (predominantly hypointense with alternating smaller hyperintense areas), and homogeneously enhanced with contrast [Figure 2a-c]. This was confirmed on the immediate postoperative MR [Figure 2d-e].
Representative pathologic images: (a) uniform small, basophilic, ovoid to spindle cells with oval nuclei and ill-defined cytoplasm, and numerous thin-walled ramifying blood vessels. (Hematoxylin and eosin stain). Strong staining is present for CD34 (b) and bcl-2 (c).
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F3
The final diagnosis of a SFT with no malignant features (WHO Grade I) was then established [Figure 3].