case_images: PMC9168293_01
case_images: Preoperative axial (a) and sagittal (b) thoracic spine MRI sequences showed a T7-T9 intradural extramedullary dumbbell-shaped lesion with intense post contrastographic enhancement. Also, this lesion appears hypointense on T2-weighted images (c) and hyperintense on STIR sequences (d).
case_images: SNI-13-199-g001.jpg
case_images: PMC9168293_01_SNI-13-199-g001.jpg
case_images: F1
case_images: T9 (i.e., maximal width T8) levels contributing to severe spinal cord compression [Figures 1a-d]. This lesion was hypointense on T1/T2-weighted images [Figure 1c], hyperintense on STIR sequences [Figure 1d], and intensely enhanced with contrast [Figures 1a and b]. The whole-body PET-CT-scan revealed multiple diffuse osteoblastic lesions, and the high level of a radioactive tracer involving the 8th/9th ribs bilaterally, sternum, pelvis, and C6-C7 and T3 pedicles. Immunostaining showed a positive check for chromogranin and synaptophysin [Figures 3a and b] [Table 1].
case_images: Postoperative sagittal thoracic spine MRI sequences showed a complete endospecal removal of the lesion images on STIR (a) and T2 sequences (b).
case_images: SNI-13-199-g002.jpg
case_images: PMC9168293_01_SNI-13-199-g002.jpg
case_images: F2
case_images: The 1-week postoperative thoracolumbar MRI documented complete removal of the extradural tumor [Figures 2a and b].
case_images: Immunostaining showed the two most specific and sensitive markers capable of defining the neuroendocrine nature of the neoplasm: Synaptophysin: diffuse and intense cytoplasmic positivity in about 90% of neoplastic cells. (a) Chromogranin-A: granular cytoplasmic positivity (dot-like) in about 90% of neoplastic cells (b).
case_images: SNI-13-199-g003.jpg
case_images: PMC9168293_01_SNI-13-199-g003.jpg
case_images: F3
case_images: Immunostaining showed a positive check for chromogranin and synaptophysin [Figures 3a and b] [Table 1].
case_images: Hematoxylin and eosin stain image showed nuclear atypia, with diffuse "salt and pepper" chromatin.
case_images: SNI-13-199-g004.jpg
case_images: PMC9168293_01_SNI-13-199-g004.jpg
case_images: F4
case_images: The combination of studies allowed for documentation of a well-differentiated neuroendocrine neoplasm (i.e., NEN sec WHO 2019) [Figure 4].