PMC5473076_01
Magnetic resonance imaging of the spine. (a) T2 sagittal, (b) T2 axial, (c) sagittal contrast, (d) axial contrast images, showing a well-defined intradural extramedullary mass lesion at D8 level
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F1
In addition, it was accompanied by multiple sclerotic lesions consistent with multifocal metastatic disease [Figure 1].
Operative images showing (a) location of meningioma ventral to the cord (asterix), (b) excision of meningioma, (c) after complete removal
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F2
A complete surgical excision of the T8 extramedullary ventral lesion was performed; it was very firm and adherent to the dura [Figure 2].
(a) H and E stained preparation shows histology typical of a meningioma in the background, with the alien dark staining cells (asterix) representing metastatic involvement by a carcinoma. (b and c) Immunohistochemistry showing metastatic carcinoma cells positive for nuclear CDX2 and CK7
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F3
Histopathologically, the mass consisted of both a meningothelial meningioma and diffuse metastatic deposits of a poorly differentiated adenocarcinoma arranged in nests and cords with microacinar structure [Figure 3a-c].