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Intramedullary gliofibroma: MR, ultrasound, and pathologic correlation
T R Windisch1, L G Naul, S C Bauserman
1Department of Radiology Scott & White Clinic, Temple, TX, USA.
Abstract:
We describe the clinical, MR, ultrasound, and pathologic findings of an intramedullary gliofibroma. This uncommon primitive tumor is thought to be of mixed glial and mesenchymal origin. Although the majority of tumors described to date have been histologically benign, clinical course has been quite variable. On MRI, the tumor we report was isointense to adjacent spinal cord on T1-weighted imaging and became hyperintense on proton and T2-weighted imaging. Enhancement with gadolinium diethylenetriamine pentaacetic acid was mild and slightly heterogeneous. Intraoperative ultrasound demonstrated widening of the lower thoracic cord. Echo pattern was generally similar to that of adjacent cord. The major differential diagnostic considerations include astrocytoma and ependymoma.
Insights
This study details an intramedullary gliofibroma, an uncommon spinal cord tumor of mixed glial and mesenchymal origin. Imaging revealed characteristic MRI and ultrasound findings, aiding in differential diagnosis from other spinal cord tumors.
Area of Science:
- Neuro-oncology
- Spinal Cord Pathology
Background:
- Intramedullary gliofibromas are rare tumors with debated origins, potentially arising from mixed glial and mesenchymal tissues.
- While often histologically benign, their clinical progression is highly variable.
Observation:
- This case presents a gliofibroma within the spinal cord.
- Magnetic Resonance Imaging (MRI) showed the tumor as isointense on T1-weighted images and hyperintense on proton and T2-weighted images.
- Gadolinium enhancement was mild and heterogeneous; intraoperative ultrasound indicated spinal cord widening with a similar echo pattern.
Findings:
- The described imaging characteristics aid in the diagnosis of intramedullary gliofibroma.
- The tumor exhibited specific signal intensities and enhancement patterns on MRI.
- Ultrasound findings correlated with tumor presence and spinal cord involvement.
Implications:
- Accurate diagnosis of intramedullary gliofibroma is crucial for appropriate patient management.
- Distinguishing gliofibroma from other intramedullary tumors like astrocytoma and ependymoma is essential.
- Understanding the imaging features can improve diagnostic accuracy and guide treatment strategies.