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19b - Answer: Cervical intramedullary spinal cord tumor

David Yousem MBA, MD
David M Yousem, MBA, MD
Professor of Radiology, Vice Chairman and Associate Dean
Includes DICOM files

Learn more about this case by reading the case report below. Additional instruction is provided in the Case Summary section of the course.

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Case Report

HISTORY: Cervical intramedullary spinal cord tumor

TECHNIQUE:
 
Sagittal T1 weighted, sagittal T2 weighted, sagittal STIR, axial T2W, and axial 3D gradient echo scans were performed through the cervical spine. Post contrast scans after administration of gadolinium contrast agent at a dose of 0.1 mmol/kg were also performed.
 
FINDINGS:
 
The alignment of the vertebral bodies shows straightening.
The signal intensity of the vertebral bodies shows no abnormalities.
The signal intensity of the spinal cord is remarkable for a mass in the cervical spinal cord extending from the mid C3 level to the bottom of C4 measuring approximately 2.4 cm in superior-inferior dimension and 0.6 cm in AP dimension and approximately 0.7 cm in transverse dimension. The cord is mildly expanded and there is
an enhancing nodule amidst the expanded cord measuring a maximum superior-inferior dimension of 8.5 mm. The lesion is central within the spinal cord and has a transverse diameter measuring approximately 7 mm.

There is superimposed mild degenerative changes in the cervical spine with disc bulges at C5-6 and C6-7. A small hemangioma of bone is seen in the anterior inferior vertebral body of C7.

When compared with previous study from January 28, 2015 the size of the enhancing nodule measured 8.5 mm in superior-inferior dimension at that time as well as 6 mm in transverse dimension. The difference is within
normal variation of measurements. The sagittal STIR images are similar in appearance as well. When compared with
the enhancing nodule from August 18, 2013 superior-inferior dimension was 8 mm.
  
IMPRESSION:
 
Probable spinal cord hemangioblastoma with cystic and solid components with the solid nodule not significantly changed in size from previous studies or very slightly increased since Georgetown study from 2013.

LESSON 5, TOPIC 12

Case Challenge: Spine MRI Cases - I-MED Study

Content reviewed: May 12, 2022