Spinal neurofibroma/Schwannoma

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Low back pain with left sciatica.

Patient Data

Age: 45 years
Gender: Male
  • a well-defined fusiform soft tissue mass lesion is seen along the exiting left L3 nerve root which shows gross thickening. The mass shows isointense T1 and hyperintense T2 signal intensity
  • the mass measures 3 x 2.6 x 1.7 cm in its main CC and axial diameters, respectively
  • the mass causes pressure effect with mild scalloping of the left vertebral body posterior aspect and some widening of the related exit foramen, the lesion is seen indenting the left psoas muscle
  • there is associated left inter-vertebral foraminal disc extrusion
  • degenerated L3/L4, L4/L5 and D11/D12 discs with decreased bright T2 signal

State of the art MSCT with coronal and sagittal reformatting nicely demonstrates the mass along its whole course and shows the vertebral scalloping; indicating a long-standing benign lesion.

Case Discussion

This case shows a classic spinal neurofibroma/schwannoma with intraspinal and extraspinal components, posterior vertebral scalloping and relative widening of the related exit foramen.  There is associated left inter-vertebral foraminal disc extrusion.

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