PMC5324366_01
(a) Sagittal view and (b) axial view of T2 weighted magnetic resonance imaging spine showing intradural extramedullary mass with extradural component. (c) Axial view and (d) coronal view of contrast enhanced computed tomography scan showing left paravertebral mass
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F1
Multiple intralesional necrotic/cystic areas are seen [Figure 1a and b]. The mass was seen passing through D10-D12 neural foramina and causing its widening and extending into spinal canal causing rightward displacement of spinal cord [Figure 1c and d].
(a) Tumor is cellular and in diffuse growth pattern (H and E, x100). (b) Tumor cells are round to oval with finely granular chromatin, indistinct cytoplasmic boundaries, and showing few mitosis (H and E, x400). (c) CD34 is diffusely positive in tumor cells. (d) Ki-67 proliferation index is ~5-7%
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F2
Histopathology examination (HPE) features were suggestive of SFT [Figure 2a and b]. S100, CD117, DOG1 on immunohistochemistry (IHC) [Figure 2c and d]. She was then referred to General Surgery Department of our institute where she was investigated for distant metastases which was negative, and then she underwent thoracotomy and excision of left paravertebral tumor.
(a) Axial view and (b) Sagittal view of T2 weighted magnetic resonance imaging of spine showing residual tumor
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F3
MRI whole spine and positron emission tomography (PET) scan was performed for assessment of extent of disease. MRI revealed a residual mass at the level of D11-D12 neural foramina on left side (1.5 cm x 1.2 cm x 1.5 cm) [Figure 3a and b] with mild fluorodeoxyglucose uptake and multiple subcentimetric nodular lesions in bilateral lungs suggestive of metastases on PET scan.