Age: 33
Sex: Male
Indication: Neck pain, prior surgery for neck tumor
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Case #5
Findings
- Status post bilateral C3-C5 laminectomies
- Abnormal patchy T2/STIR hyperintensity in the cervical spinal cord, particularly dorsally, spanning C2-C3 through C7-T1 with associated mild cord expansion from C3-C4
- More discrete, smaller enhancing nodules eccentrically located within the cervical spinal cord from C3-C7 as well as at the cervicomedullary junction and in the incompletely imaged bilateral cerebellar hemispheres and vermis
- At C5-C6, a posterior disc-osteophyte complex indents the ventral cord and in combination with ligamentum flavum thickening results in moderate spinal canal stenosis without significant neural foraminal stenosis
- At C6-C7, a posterior disc-osteophyte complex mildly flattens the ventral cord and contributes to mild spinal canal stenosis. Uncovertebral hypertrophy contributes to moderate left neural foraminal stenosis
Diagnosis
- Hemangioblastomas
Sample Report
Multiple eccentric intramedullary enhancing nodules in the cervical spinal cord from C3-C7 with surrounding nonenhancing T2/STIR hyperintensity and mild cord expansion. Additional enhancing nodules at the cervicomedullary junction and in the incompletely imaged bilateral cerebellar hemispheres and vermis. These findings are particularly concerning for multifocal hemangioblastomas, which can be seen with von Hippel Lindau disease. Recommend completing MR imaging of the neural axis (brain, thoracic, and lumbar spine MRI with and without contrast) for further assessment.
Status post bilateral C3-C5 laminectomies without significant spinal canal stenosis at these levels. Posterior disc-osteophyte complexes contribute to moderate spinal canal stenosis at C5-C6 and mild spinal canal stenosis at C6-C7. Moderate left neural foraminal stenosis at C6-C7.
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