case_images: PMC3872659_01
case_images: Pre-operative T1 magnetic resonance imaging (MRI) with gadolinium sagittal (a) MRI showing an enhancing lesion at the occiput to C4 levels with severe spinal cord compression and a small enhancing lesion seen at the upper thoracic spine (T2-3). H and E staining (b) with dense cellularity and oval shaped nuclei forming fascicles. CD34 staining (c) demonstrating the classic staghorn vascular channel, original magnification x200. 5-year post-operative sagittal T1 MRI with gadolinium (d) showing no evidence of cervical or thoracic disease
case_images: JCVJS-4-32-g001.jpg
case_images: PMC3872659_01_JCVJS-4-32-g001.jpg
case_images: F1
case_images: The gadolinium-enhanced cervical spine magnetic resonance imaging (MRI) revealed an intradural extra-medullary lesion extending from the occiput to C4 in the ventrolateral position with central stenosis and cord compression [Figure 1a]. In addition, there was a small enhancing lesion seen at the upper thoracic spine [Figure 1a]. Immunostaining revealed the tumor was positive for CD34 and B-cell lymphoma 2, but negative for smooth muscle actin, epithelial membrane antigen, synaptophysin and glial fibrillary acidic protein and a Ki-67 proliferative index of 12% [Figure 1]. Five years post-operatively, he is neurologically at baseline and follow-up MRI [Figure 1] reveals no evidence of recurrence in either the cervical or thoracic regions.