Spinal myxoid neurofibroma

Case contributed by RMH Neuropathology

Presentation

Left flank neuropathic pain at T10 level.

Patient Data

Age: 39
Gender: Male

MRI Thoracic spine

Modality: MRI

Note made of transitional anatomy. There are 7 cervical vertebrae,

13 thoracic type

vertebrae with 13 pairs of ribs, and 5 lumbar type vertebrae.

At T10/11 there is an ovoid intradural extramedullary mass which causes leftward displacement and severe compression of the cord, with subtle T2 hyperintensity in the adjacent cord. The mass is vividly T2 hyperintense and T1 hypointense, with vivid enhancement but irregular central region of non-enhancement. There is no extension into the right T10/11 foramen. No dural tail of enhancement.

No further mass or region of pathological enhancement. The remainder of the cord demonstrates normal signal, and there is no thoracic disc herniation.

T2 sagittal screening images through the lumbar spine have been performed, which demonstrate 8 mm L4/5 retrolisthesis of L5/S1 anterolisthesis in the context of bilateral L5 pars defects and bilateral L4/5 facet arthropathy. This does not cause canal stenosis or neural impingement.

Conclusion

Right posterolateral intradural extramedullary mass at T10/11 level causes severe cord compression and oedema. Lesion is likely neurogenic tumour; signal characteristics would be very atypical for meningioma.

Modality: Pathology

MICROSCOPIC DESCRIPTION: Paraffin sections show a moderately hypercellular neurofibroma. Tumour cells have mildly pleomorphic vermiform nuclei with delicate and coarse bipolar processes. These are dispersed haphazardly within a myxoid stroma. No mitotic figures, densely hypercellular areas or areas of necrosis are identified. Tumour is enclosed within a thin fibrous capsule. No extracapsular extension of tumour is seen. 

DIAGNOSIS: T10-11 ?neurofibroma: Neurofibroma.

Case Discussion

This case illustrates a spinal neurofibroma, which is a benign, localised, and peripheral nerve sheath tumour. 

 

 

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Case Information

rID: 39172
Case created: 24th Aug 2015
Last edited: 2nd Sep 2015
Inclusion in quiz mode: Included

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