 |  |  |
| T1 sagittal pre gad | T1 sagittal post gad | T2 sagittal |
Diagnosis: Meningioma
Meningiomas represent 1/4 of all spinal neoplasms and are second in number to schwannoma. Most patients are women above the age of 40 presenting with progressive neurological deficit. 90% are intradural extramedullary and most are located in the thoracic spine. Calcification is seen on CT in less than 5% of cases. Spinal meningiomas are usually isointense with cord on T1 have variable signal on T2, usually enhance homogeneously and have a broad dural attachment with a dural tail. Metastases and lymphoma of the spine typically present as destructive masses which may cause pathologic collapse of the involved vertebral bodies with an epidural soft tissue component. Dural metastases may simulate a meningioma. Schwannoma is in the differential for spinal meningioma as well. 70% of spinal schwannomas are intradural, 15% are extradural and 15% are combined intra and extradural and often have erosion of the neural foramen. They typically enhance homogeneously, but are not dural based as in this case. Related Cases
