Presentation
Back pain.
Patient Data
Intradural extramedullary soft tissue intensity space-occupying lesion involving the most caudal aspect of the spinal cord as well as the cauda equina at L1 level. It is mildly T1 hypointense and T2 iso- to hypointense, with central areas of fluid intensity reflecting internal cystic degeneration. The lesion enhances vividly after contrast injection, with areas of central breakdown. Small flow voids (vessels) surround the lesion as well as within the lesion matrix. The lesion exerts a mass effect in the form of displacement of the related segment of the cord anteriorly and to the right, as well as anterior displacement and splaying of the cauda equina nerve roots.
Case Discussion
Spinal nerve sheath tumors are the most common intradural extramedullary masses. Spinal schwannoma and neurofibroma are often indistinguishable radiologically. The lesion was surgically removed and the pathology report for this lesion confirmed that is a spinal schwannoma.
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