Case
A 73-year-old male patient with a two month history of sudden onset
numbness, gradual weakness in the lower extremities accompanied by
walking difficulty was examined. 10 days before admission his symptoms
progressed to paraparesis. Magnetic resonance imaging (MRI) showed an
intramedullary mass of 73 x 9 x 8mm at the thoracic spinal cord
extending from T6 to T8. On T1 weighted images hypointense
intramedullary lesion. T2w weighted images showed hyperintense lesion,
signal intensity higher than cerebrospinal fluid.
The patient was transferred from a primary healthcare facility with a
past medical history of controlled hypertension and DM II. History of
chronic pelvic pain syndrome was reported. Any evidence of prostate
cancer or other primary systemic tumors were excluded. Moreover, there
was no evidence of any other spinal or intracranial lesion. LP was
negative for malignant cells.
He underwent unilateral T7 Hemilaminectomy through posterior approach.
Intraoperatively the tumor appeared noncystic and gelatinous. Partial
surgical resection was performed, as well as a biopsy was taken for
pathological analysis. A histopathological laboratory disclosed that the
tumour tissue consisted of bipolar cells with tendency of perivascullar
arrangement, embeded in myxoid matrix, Rosenthal fibers were not found.
On immunohistochemistry, tumour cells were positive for S-100, GFAP,
OLIG2, SOX10 and focally for Synaptophysin. Tumour cells were negativne
for panCK (AE1/AE3) and EMA. Mitoses were rare. Proliferative Ki-67
index ranged up to 4%.[figure 1&2].
After surgery the patient had no improvement. He was refered to recieve
external beam radiation therapy