Figure 1. Sagittal
(A) and axial (B) T2 weighted images. Pre-operative picture shows
epidural vertebral canal tissue (arrow heads in A and asterisks in B),
located from D7 to D11, slightly hyperintense to the medullary nervous
tissue. The lesion compresses and dislocates the dural sac and its
contents antero-laterally, towards the left (arrow in B), with
extension, through the right conjugation foramen, into the adjacent
cost-vertebral space (asterisk in A). An area of altered signal,
expression of medullary suffering, at level D11-D12 (arrows in A) is
associated.Sagittal (C) and axial (D) T2 weighted images. Post-operative
picture after the removal of the neoformation, with resolution of the
associated mass effect (arrowheads in C) and the area of medullary
suffering. Noteworthy is the prompt response to chemotherapy of the
extended component in the right costovertebral space.
Figure 2. Sagittal T2 weighted (A) and T1 weighted images after
contrast administration(B). Before surgery picture was characterized by
intravertebral epidural neoformation, located in the D1-D3 tract
(arrowheads in A and asterisks in B), characterized by a signal similar
to the that from the spinal cord in T2, because of high cellularity, as
well as by lower contrast impregnation (asterisks in B). The lesion
described engages almost entirely the spinal canal, with a marked
compressive effect on the dural sac and its contents (white arrows in
A), dislocated laterally to the left (black arrow in B). The
neoformation extends into the costovertebral adipose tissue through the
intervertebral foramina, on the left side.Sagittal (C) and axial (D) T2 weighted images. Post-operative
picture characterized by the removal of the lesion (arrowheads in C),
with a reduction of the associated mass effect. On the post-operative
phase, the spinal cord early appears distorted by previous compression
(arrows in C and D), however, without radiological features of
suffering.