case_images: PMC9939244_01
case_images: Sagittal magnetic resonance imaging findings.. (A) Preoperative T1 image with contrast. (B) Preoperative T2 image. (C) Post-biopsy and drainage T1 image with contrast. (D) Post-biopsy and drainage T2 image. (E) Post-resection T1 image with contrast. (F) Post-resection T2 image.
case_images: cureus-0015-00000034017-i01.jpg
case_images: PMC9939244_01_cureus-0015-00000034017-i01.jpg
case_images: FIG1
case_images: C7 pedicle. T2 central hypodensity extended beyond the cyst to the level of the T1-2 disc space, concerning for either infiltrative tumor, pre-syrinx, or syrinx with surrounding edema (Figures 1A, 1B). Contrasted T1 scans showed an irregular enhancement pattern along the superior tumoral border down to the C3 pedicle. Postoperative MRI revealed a well-demarcated more homogenously enhancing mass extending from the foramen magnum to C2 in addition to a caudal polar cyst with a resolution of pre-syrinx edema (Figures 1C, 1D). Post-resection, no residual enhancement was seen, and the hemosiderin cap was seen centrally adjacent to the C2-3 disc space (Figures 1E, 1F).
case_images: Intraoperative image.. Intraoperative photograph at second-stage resection. White tubing in the center of the canal is the syringo-subarachnoid shunt tube. Normal spinal cord and dorsal columns are seen as white linear structures along either side of the dark pink mass below the pial surface, which is ependymoma.
case_images: cureus-0015-00000034017-i02.jpg
case_images: PMC9939244_01_cureus-0015-00000034017-i02.jpg
case_images: FIG2
case_images: She underwent a C1 laminectomy for open biopsy and cysto-subarachnoid shunt, which can be seen in the second-stage intraoperative photograph in Figure 2. As seen in Figure 2, the tumor borders appear well-defined.