Presentation
Cervical pain in a patient with known neurofibromatosis type 1 (NF1).
Patient Data
Intradural extramedullary dumbbell lesion traversing and widening the left C1-C2 neural foramen and focally compressing the spinal cord. The lesion is slightly hyperintense to muscle on T1WI, shows heterogeneous signal on T2WI, and enhances moderately after contrast administration. Features are most compatible with schwannoma.
C2-C3: medial disc herniation, exerting pressure on the thecal sac but not on the cord.
Innumerable cutaneous neurofibromas on the occipital scalp, neck, and torso.
Was involved in a motor vehicle accident as a pedestrian 4 years after the MRI study was done. Total body CT ordered.
Total body CT - head- non-contrast:
No trauma-related findings.
Dumbbell lesion hypodense to muscle measuring 2.0x2.6x3.0 cm traversing the left neural C1-C2 foramen, widening said foramen and compressing the thecal sac; cf. the MRI study, the lesion has slightly widened and with it, the foramen.
Innumerable nodules scattered over the scalp.
Case Discussion
Slow-growing intradural-extramedullary tumor in the cervical spine of a neurofibromatosis type 1 (NF1) patient exhibiting features most compatible with a schwannoma.
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