Demographics:
17 years old, Male
Indication:
Stage IV rhabdomyosarcoma, new ataxia
Findings
- Linear and nodular enhancement along the surface of the conus and cauda equina nerve roots extending into multiple lumbar and sacral neural foramina
- Clumping and peripheralization of nerve roots of the cauda equina resulting in an "empty thecal sac" appearance
- Normal marrow signal
- Normal alignment
- No significant degenerative changes
Diagnosis
Leptomeningeal metastatic disease with arachnoiditis
Sample Report
Linear and nodular enhancement along the surface of the conus and cauda equina nerve roots extending into multiple lumbar and sacral neural foramina concerning for leptomeningeal metastatic disease in this patient with known metastatic cancer. Recommend completion MR imaging of the neural axis (brain, cervical, and thoracic spine MRI with and without contrast) for further assessment.
Clumping and peripheralization of nerve roots of the cauda equina consistent with arachnoiditis.
Discussion
References