T2 and isointense in Tl with peripheral capsular enhancement with no central enhancement in the delayed phase. The largest lesion measured 5.1 x 2.6 x 4.4 cm insin- uated through the anterior and posterior right cervical triangular space, encasing the carotid sheath and also reaching to the retropha- ryngeal and paraspinal spaces in the same side. The other lesions were seen as following; internal surface of the left mid thoracic cage, right paratracheal area, the inner surface of the lower right ribs which abutting theanterior surface of the right hepatic lobe with no involve- ment of the liver, in the posterior paraspinous space at level of L2 to L5, the posterior aspect of the iliac bone bilaterally in the gluteus re- gion, in the medial aspect of the left femoral head, few lesions noted in the lower thighs bilaterally, mainly in the lateral aspect with some involvement of the adjacent femoral bone mainly noted in the left dis- tal metaphysic [Fig. 3A, B and C]. Surgical biopsy from the right par- avertebral mass carried out, histologic examination revealed a nodu- lar growth pattern on low power. There was vascular and spindle cell proliferation. The blood vessels were thin-walled and irregularly branching (hemangiopericytoma-like). The myofibroblasts at the cen- ter of the lesion are polygonal or round with large hyperchromatic nu- clei while the peripheral myofibroblasts are spindle shaped with elon- gated nuclei and vesicular chromatin. The mitotic activity was low and reaches 2/10 HPF at some foci [Fig. 4]. Patient remained stable during hospitalization, hypersalivation decreased gradually. At the age of 5-months patient was sent home on NGT feeding.
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