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Nonenhancing spinal subdural metastatic tumor.
Zoran Rumboldt1, Lara Lambert, Jasna Talan-Hranilovic
1Department of Radiology, Medical University of South Carolina, Charleston, SC 29425, USA.
AJNR. American Journal of Neuroradiology
|October 13, 2005
Summary
A spinal subdural metastatic tumor rapidly caused symptoms after trauma due to severe cord compression and hemorrhage. MR imaging revealed a hemorrhagic tumor without contrast enhancement, mimicking a hematoma.
Area of Science:
- Neurology
- Radiology
- Oncology
Background:
- Spinal subdural metastatic tumors are rare and can present with diverse clinical and radiological features.
- Trauma can precipitate rapid neurological deterioration in patients with spinal lesions.
Observation:
- A case of a spinal subdural metastatic tumor is presented.
- The tumor became rapidly symptomatic following minor trauma, leading to severe spinal cord compression and hemorrhage.
Findings:
- Magnetic Resonance (MR) imaging demonstrated an oval lesion.
- The lesion exhibited specific signal characteristics: hyperintense with a dark rim on T2-weighted fast spin-echo images, isointense to the cord on T1-weighted images, and heterogeneous signal on gradient-echo T2*-weighted images.
- These findings were consistent with a hyperacute-to-acute hematoma, and importantly, the hemorrhagic tumor showed no contrast enhancement.
Implications:
- This case highlights the importance of considering hemorrhagic metastatic tumors in the differential diagnosis of acute spinal cord syndromes, especially after trauma.
- The characteristic MR imaging findings, particularly the absence of contrast enhancement in a hemorrhagic lesion, are crucial for accurate diagnosis.
- Prompt recognition and management are essential to prevent irreversible neurological deficits.