case_images: PMC11802189_01
case_images: The MRI of the lumbar spine reveals a heterogeneously well-circumscribed mass at the L5 level that is iso-intense on T1-weighted (T1W) image (A) and hyper-intense on T2-weighted (T2W) image (B), enhanced after the contrast injection on the sagittal plane (C), coronal plane (D), and axial plane (E).
case_images: cureus-0017-00000077096-i01.jpg
case_images: PMC11802189_01_cureus-0017-00000077096-i01.jpg
case_images: FIG1
case_images: The lesion was intradural, extramedullary, centrally located, and slightly displaced to the left (Figure 1).
case_images: (A) Intraoperative image with a well-defined tumor (white arrowhead) compressing the L5 nerve root (black arrowhead). (B) The tumor is completely removed with the preservation of the nerve root (yellow arrowhead). (C) After determining the histopathological type of MPNST, the patient undergoes radiation therapy at the L5 level.
case_images: cureus-0017-00000077096-i02.jpg
case_images: PMC11802189_01_cureus-0017-00000077096-i02.jpg
case_images: FIG2
case_images: Reconstruction involved dural repair and closure of the laminectomy site from L4 to S1 (Figure 2).
case_images: Histopathology shows positive for nuclear factor (NF) (A), S-100 (B), P53 (C), H3K27me3 (D), SOX-10 (E), and a high proliferation rate with Ki-67 14.1% (F).
case_images: cureus-0017-00000077096-i03.jpg
case_images: PMC11802189_01_cureus-0017-00000077096-i03.jpg
case_images: FIG3
case_images: H3K27me3 staining was weakly positive, further supporting the MPNST diagnosis (Figure 3).
case_images: An MRI obtained nine months after surgery showed that the extradural intramedullary tumor was completely removed on the sagittal plane on T1-weighted (T1W) image (A), on T2-weighted (T2W) image (B), and after contrast injection with the sagittal plane (C), coronal plane (D), and axial plane (E).
case_images: cureus-0017-00000077096-i04.jpg
case_images: PMC11802189_01_cureus-0017-00000077096-i04.jpg
case_images: FIG4
case_images: Follow-up MRI confirmed complete resection of the intradural extramedullary mass (Figure 4).