Thoracic spinal schwannoma

Case contributed by Dr Shankar Poudel

Presentation

Back pain.

Patient Data

Age: 83 years
Gender: Male
MRI

There is a well defined vividly enhancing T1 isointense, T2 hyperintense extramedullary intradural lesion at T9-T10 level. There is also a non-enhancing hypointense area within lesion. 

Case Discussion

The diagnosis is most likely of schwannoma. However, histological proof is not available.

Schwannomas are the most common intradural extramedullary spinal tumor. They are most frequently seen in the cervical and lumbar region, far more frequently than in the thoracic spine.

On imaging, they are usually characterized as iso or low T1 and high T2 MRI signal, and showing vivid contrast enhancement. The signal intensity can be heterogeneous due to associated hemorrhage, intrinsic vascular changes (thrombosis, sinusoidal dilatation), cyst formation and fatty degeneration. 

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