14 year-old with low back pain radiating down both legs



     
T1 sagittal  noncontrast                                                                                                 T2 sagittal



     
T1 sagittal post Gad                                                                                                                    T1 axial post Gad
                     


Findings:

Lobulated intradural mass at the L3 level which displaces the nerve roots circumferentially, but predominantly laterally. Relative to the spinal cord, it is isointense on T1, and hyperintense on T2. It avidly enhances in a near homogeneous fashion with gadolinium

DDX:

Intradural spinal mass: ependymoma or schwanomma


Diagnosis:

Myxopapillary ependymoma.


Discussion:

Spinal ependymomas are more rare than intracranial types. Most are of the myxopapillary type related to conus or filum terminal and present in patients aged 20-40 years. Intramedullary ependymomas have been associated with neurofibromatosis type


Submitted by Anthony Giauque, MD, UW Neuroradiology Fellow

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