Presentation
History withheld.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/1808316/73ae5c730ee19eb5ce75bf97e5e89d_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/1808412/03f14d2c9bda51e716272ef99be595_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/1808384/76b7c353c122bfe2397da4c4db332c_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/1808316/73ae5c730ee19eb5ce75bf97e5e89d_big_gallery.jpg)
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.
![](https://prod-images-static.radiopaedia.org/images/1808275/7b9132c930ebec6cc601f12edfe13b_thumb.jpg)
![](https://prod-images-static.radiopaedia.org/images/1808282/2ec46f395c4a562c993beede359c9a_thumb.jpg)
![](https://prod-images-static.radiopaedia.org/images/1808275/7b9132c930ebec6cc601f12edfe13b_big_gallery.jpg)
MRI shows a T2-hyperintense, somewhat heterogeneous lesion, that enhances avidly, but only at the periphery.
Case Discussion
Biopsy-proven Schwannoma at the L4 level on the right known for several years. The patient refused operative treatment.
In contrast with osteolysis, scalloping is characterized 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. Localized scalloping may also be caused by slowly growing intraspinal masses 1.
MR images courtesy of Dr. Christoph Gill.