A Rare Case of Concomitant Intramedullary Gangliocytoma at the Cervicomedullary Junction in Patient with Neuroendocrine Tumor of Lung

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revealed a 45×14 mm sized mass lesion mixed with cystic and solid components, calcification foci extending from medulla oblongata to C2 level, with edema or infiltration areas extending to C6 level, and the mass was heterogeneous on T1-weighted MR imaging, hyperintense on T2-weighted MR imaging and solid components showed intense contrast-enhancing following injection of Gadolinium (Gd) (Fig. 1).Metastasis was considered in the first place in preliminary diagnosis.The patient was scheduled for surgery.Suboccipital craniectomy and C1 laminectomy were performed following brainstem mapping with neurophysiological monitoring.The dura was opened in the midline.Cervicomedullary junction was found to be enlarged.After midline myelotomy, a stiff-structured gray tumor with unclear boundaries was encountered.Partial resection was performed with the help of ultrasonic aspirator (Fig. 2).Operation was terminated upon detection of increase in temporary somatosensory evoked potential latencies and decrease in motor evoked potential amplitudes during the operation.Postoperative neurological examination was intact.On microscopic examination, intense inflammation, lots of ganglion cells with focal calcification that stained positively with S100 and synaptophysin.No obvious glial component was detected with glial fibrillary