Progressive paresthesia of the extremities. History of multiple surgical treatments for hydrocephalus.
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The MRI shows a T2 hyperintense mass in in the dorsal myelon with intralesional cystic components in the apical region. The mass does not enhance after intravenous contrast administration and is predominately isointense on T1.
Astrocytomas of the spinal cord are rare tumors that arise from astrocytes in the spinal cord and occur in the adult and pediatric populations. Astrocytomas account for approximately 30% of spinal cord tumors.
In this case there is no association with a NF1, so there is less probability of a pilocytic variant.
Nonenhancing intramedullary astrocytomas are not uncommon and comprise between 20% and 30% of intramedullary astrocytomas.