Schwannoma with vertebral scalloping

Discussion:

Biopsy-proven Schwannoma at the L4 level on the right known for several years. The patient refused operative treatment.

In contrast with osteolysis, scalloping is characterized by a smooth margin with rim sclerosis towards the spinal canal. In the spine, it is caused by a mismatch between intra-spinal pressure and bone stability. Systemic disorders, that may lead to vertebral scalloping are connective-tissue diseases, mucopolysaccharidoses, neurofibromatosis type I or ankylosing spondylitis. Localized scalloping may also be caused by slowly-growing intraspinal masses 1.

MR images courtesy of Dr. Christoph Gill.

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