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

We present the FDG PET/CT findings of an intradural spinal malignant peripheral nerve sheath tumor (MPNST) in a 34-year-old woman with a 9-month history of progressive lower limb weakness and ascending sensory loss. Initial contrast-enhanced spinal MRI suggested infectious myelitis. However, 18F-FDG PET/CT revealed intense, linear FDG uptake along the cervicothoracic and upper lumbar spine (SUVmax 27.95), raising concern for a malignant process. Subsequent histopathologic analysis confirmed the diagnosis of MPNST.