case_images: PMC5794353_01
case_images: Magnetic resonance images at the initial visit (A, B, G), postoperation and after 1 cycle of chemotherapy (C, D), and at the latest follow-up (May 29, 2017) (E, F, H, I). (A, B) Sagittal plane at T6-7 showing abnormal lesion located in the epidural space of the thoracic spinal canal. (G) Axial planes note the mass extending through the foramen forming a paravertebral tumor (arrows). (C, D) Sagittal plane demonstrates the tumor at the thoracic spine, which had been partially resected and chemotherapy showed complete disappearance. (E, F, H, I) There was no recurrent tumor in the epidural space at the last follow-up.
case_images: medi-97-e9329-g002.jpg
case_images: PMC5794353_01_medi-97-e9329-g002.jpg
case_images: F1
case_images: T6 to T8 with compression of the spinal cord (Fig. 1A, B, G). The epidural mass extended through the right intervertebral foramen of T6-7, forming a paravertebral tumor of similar size. After the first cycle of chemotherapy (Fig. 1C and D), her back pain, motor weakness, and urinary dysfunction showed remarkable improvement. After 4 cycles, her MRI of spine confirmed continuing clinical remission of the primary lesion and right iliac wing (Fig. 1E, F, H, I).
case_images: Positron-emission tomography (PET) was taken to classify the stage of the disease. Uptake in the spinal canal at T6-8, right iliac wing and right liver were clearly observed.
case_images: medi-97-e9329-g003.jpg
case_images: PMC5794353_01_medi-97-e9329-g003.jpg
case_images: F2
case_images: T6-8 level (SUVmax = 8.74), right iliac wing (SUVmax = 9.05), and right liver (SUVmax = 8.35) presented abnormal 18-fluorodeoxyglucose (18-FDG) uptake (Fig. 2). Taking together tumor and surgical destruction and distant metastases was considered.