Figure 4
A case of spinal metastasis (SM). A 15-year-old male with synovial sarcoma over the left knee and pulmonary metastasis had undergone tumor resection and radiotherapy. Twenty-two months after the initial diagnosis, follow-up chest CT revealed an osteolytic lesion at the T7 spine with partial collapse of the vertebral body (a). MRI revealed hypointensity on T1WI (b), strong enhancement on contrast-enhanced T1WI (c), and isointensity on T2WI (d). Tc99m bone scan revealed avid uptake over T7 (e, arrow). The T7 lesion appeared osteolytic on axial CT image (f). Axial contrast-enhanced MRI T1WI at the T7 level revealed enhancing lesions with expansile changes, paraspinal soft tissue (g, arrow), epidural soft tissue (g, arrowhead), and obliteration of the basivertebral vein. Bone metastasis was histologically proven by T7 corpectomy (H&E staining) (h).
