Intradural Spinal Malignant Peripheral Nerve Sheath Tumor on 18F-FDG PET/CT

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Intradural spinal malignant peripheral nerve sheath tumors (MPNSTs) are rare and can present with nonspecific symptoms.
• Distinguishing MPNSTs from other spinal pathologies like infectious myelitis can be challenging based on conventional imaging alone.

Purpose of the Study:

• To describe the 18F-FDG PET/CT findings in a confirmed case of intradural spinal MPNST.
• To illustrate the utility of 18F-FDG PET/CT in identifying malignant spinal lesions that may be misdiagnosed by MRI.

Main Methods:

• A case report detailing the clinical presentation, MRI findings, and 18F-FDG PET/CT results of a 34-year-old female patient.
• Histopathologic analysis for definitive diagnosis.

Main Results:

• Initial contrast-enhanced spinal MRI was suggestive of infectious myelitis.
• 18F-FDG PET/CT demonstrated intense, linear FDG uptake along the cervicothoracic and upper lumbar spine (SUVmax 27.95), indicating a malignant process.
• Histopathology confirmed the diagnosis of MPNST.

Conclusions:

• 18F-FDG PET/CT can be a valuable tool in the diagnosis of spinal MPNSTs, especially when initial MRI findings are equivocal.
• The intense FDG uptake observed on PET/CT raises suspicion for malignancy and aids in differentiating MPNST from inflammatory conditions.