Cauda equina mass: An Approach

-    CLINICAL PRESENTATION&FINDINGS    57 yr male with h/o low back pain with no h/o trauma presents for MRI lumbar spine which shows – Large relatively well defined , regular, intradural, subtly&heterogeneously enhancing SOL, seen from lower L3 border to middle of body of L5 with compression of cauda equina fibers, displaying mostly soft tissue signals on all sequences / normal meningeal  enhancement, with no significant hemorrhage / fat / cystic / necrosis/ MR demonstrable calcification  components / sugarcoating / scalloping or enlargement of the posterior neural elements/ dumbbell shaped extension across the neural foramina / marrow signal abnormality / soft tissue collections  -intradural neoplastic etiology is possible like astrocytoma (though no significant enhancement) / gangliogloma (though no calcification) / unusual epidermoid (though no cyst ) etc. may need consideration. Other etiology like myxopapillary ependymoma or neuroenic etiologies less likely, in view of enhancement pattern.Case Submitted by Dr MGK Murthy, Dr GA Prasad.Tumors of cauda equina&filum terminal region -Myxopapillary ependymomas arethe most common tumor of the conus medullaris and filum terminale, representing more than 90% of tumors in this region seen in young adults and usually showmarked homogeneous enhancement&may have hemorrhagic areas ( cap sign) &calcifications.Cord edema& nontumoral cysts&n...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs

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