Presentation
Weakness of the right upper limb in a patient with chronic renal failure. MRI without contrast was requested.
Patient Data
Well-circumscribed intradural extramedullary ovoid soft tissue mass of the spinal canal at the C4-C5, lateralized to the right with mild extension along the C5 nerve root. It displays an isosignal to the spinal cord on T1, moderate high signal on T2 and STIR sequences. The spinal cord is compressed and displaced to the left with no sign of myelopathy.
Mild adjacent vertebral scalloping is noted.
Substernal goiter with heterogeneously enhancing mass of the right thyroid lobe (referred to the endocrinologist for further evaluation).
Case Discussion
MRI features of an intradural extramedullary mass at C4-C5, suggestive of spinal schwannoma.
The patient underwent a complete surgical resection of the tumor with a histopathological exam confirming the schwannoma diagnosis.
Spinal schwannomas are benign nerve sheath tumors within the spinal canal arising from spinal nerve roots.
On imaging, neurofibromas and schwannomas can look identical; however, schwannomas are frequently associated with hemorrhage, intrinsic vascular changes, cyst formation and fatty degeneration. These findings are rare in neurofibromas. Please, refer to the article: spinal nerve sheath tumors.
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