Schwannoma with vertebral scalloping

Case contributed by Dr Roberto Schubert

Presentation

History withheld

Patient Data

Age: 35
Modality: CT

Large intra-extradural mass eroding the borders of the right neuroforamen and the dorsal contour of the L4 vertebral body. Marked rim sclerosis suggests a non-aggressive lesion.

Modality: MRI

MRI shows a T2-hyperintense, somewhat heterogeneous lesion, that enhances avidly, but only at the periphery.

MR images courtesy of Dr. Christoph Gill.

Case Discussion

Biopsy-proven Schwannoma at the L4 level on the right known for several years. Patient refused operative treatment.

In contrast with osteolysis, scalloping is characterised by a smooth margin with rim sclerosis towards the spinal canal. In the spine, it is caused by a mismatch between intra-spinal pressure and bone stability. Systemic disorders, that may lead to vertebral scalloping are connective-tissue diseases, mucopolysaccharidoses, neurofibromatosis type I or ankylosing spondylitis. Localised scalloping may also be caused by slowly-growing intraspinal masses 1.

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Case Information

rID: 17167
Case created: 22nd Mar 2012
Last edited: 9th May 2017
Inclusion in quiz mode: Included

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