case_images: PMC10811000_01
case_images: (A-B) MR scan on diagnosis. Coronal and transverse T2-weighted images showing spine dislocation and compression (white arrow). No significant spinal hyperintensity is seen, although the classical dumb-bell shape of the lesion (*) erases the epidural fat. (C-D) MRI after chemotherapy. Coronal and Transverse Gd-enhanced T1-weighted images: only mild enhancement is shown. The lesion had markedly decreased and the spinal cord had regained its normal position. (E-F) CT on relapse. Both abdominal (thin black arrow) and intra-canal (empty black arrow) portions are increased in volume.
case_images: fped-11-1337760-g001.jpg
case_images: PMC10811000_01_fped-11-1337760-g001.jpg
case_images: F1
case_images: Spinal magnetic resonance imaging (MRI) was performed on the second day of life and documented a 36 x 21 x 19 mm paravertebral lesion infiltrating the D10-L1 intervertebral foramina and invading the spinal canal, with displacement of the spinal cord (Figures 1A,B). A: vincristine, cyclophosphamide, doxorubicin; Cycle B: cyclophosphamide, carboplatin, etoposide) were carried out. At almost 2 monthsold, MRI revealed a marked reduction of the paravertebral mass and the disappearance of the intraspinal tumor (Figures 1C,D). One month later, and after another cycle of chemotherapy (Cycle A), a CT scan performed to document a thromboembolic event related to the central venous catheter, discovered a distinct increase in the paraspinal mass (Figures 1E,F).
case_images: Timeline of interventions and outcomes. DOL, day of life; CTX, chemotherapy; PE, physical examination.
case_images: fped-11-1337760-g002.jpg
case_images: PMC10811000_01_fped-11-1337760-g002.jpg
case_images: F2
case_images: In the subsequent few days, the patient markedly deteriorated, dying on the 106th day of life (Figure 2).