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Spinal astrocytoma

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Three months of progressive weakness of the right shoulder. No pain. Please rule out sinister pathology, nerve root compression or other cause for symptoms.

Patient Data

Age: 70 years
Gender: Male
mri

Expansion of the cervical cord between C2 and T1, most pronounced at C2 on C3,.  This is T1 isointense, T2 hyperintense.  At C2-C3 are two irregular foci of heterogenous intramedullary contrast enhancement. 

Minimal degenerative changes in the mid-cervical spine.

 

Case Discussion

The cervical cord appearances are of a primary spinal cord malignancy.  This is most likely a spinal astrocytoma, which is the commonest tumor of the cord.

The patient was referred to a tertiary center, but a biopsy was not undertaken for histological confirmation.

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