Presentation
Weakness with a tingling sensation of the upper limbs.
Patient Data
Well-circumscribed intradural extramedullary dumbbell soft tissue mass of the spinal canal at the C1-C2, lateralized to the right extensing through an enlarged neural exit foramen with vertebral scalloping. It elicits a low signal to the spinal cord on T1, intermediate signal on FLAIR and heterogeneous high signal on T2 with no restricted diffusion and heterogeneous enhancement on post-contrast sequences.
The spinal cord is compressed and displaced to the left with no sign of myelopathy.
Mild cerebral volume loss is noted
Case Discussion
MRI features of an intradural extramedullary mass at C1-C2, compressing and displacing the spinal cord most consistent with schwannoma.
Spinal schwannomas are benign nerve sheath tumors within the spinal canal arising from spinal nerve roots.
On imaging, neurofibromas and schwannomas can look identical; however, schwannomas are frequently associated with hemorrhage, intrinsic vascular changes, cyst formation and fatty degeneration. These findings are rare in neurofibromas.
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