Board Review 1 – Case 18

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case starts with a CT of the thoracic spine which demonstrates a dumbell shaped mass in the left posterior mediastinum which extends into the left sided neural foramen. There is smooth remodeling of the adjacent bone, suggesting that this is a chronic finding. MRI shows a T2 hyperintense and avidly enhancing mass.

The diagnosis is: schwannoma

Schwannomas of the spine can be intradural or extradural masses. Their characteristic appearance is an avidly enhancing mass that extends through and remodels the neural foramina. Primary differential considerations include meningioma and neurofibroma.