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2017 Case 6

Case 6

Maha Haddad1, Perry Dhaliwal2, Kenneth Aldape4, Stephen Yip3, Sherry Krawitz1

1 Department of Pathology, University of Manitoba

2 Division of Neurosurgery, University of Manitoba

3 Department of Pathology & Laboratory Medicine, University of British Columbia

4 Department of Laboratory Medicine and Pathobiology, University of Toronto

Case Summary:

A 67 year-old man presented with neck pain and hemiparesis. MRI showed a large cervical spinal intradural mass extending through the C3-C4 foramen along the C4 nerve root. Microscopically, the tumour consists of sheets of predominantly epithelioid cells with abundant eosinophilic cytoplasm and round to oval nuclei with prominent nucleoli and occasional pseudoinclusions. The tumour is heavily pigmented and highly vascular with occasional psammoma bodies. Focal cellular atypia and small areas of necrosis are identified.

Materials submitted: Digital image from H&E slides (PENDING - Slide will be added once scanned)

Questions:

What is your diagnosis?

How do you work up this case?