Spinal cystic tumor

An MRI has been considered as the best tool to investigate the spinal cystic tumor. Generally, schwannomas appears as hypointensity on T1-weighted MR images and heterogenous intensity on T2-weighted MR images, based on the different components within the schwannoma 1).

The hypointensity on T2-weighted MR images often correspond to hemorrhage, dense cellularity or collagen deposition, whereas hyperintensity may represent cystic changes 2).

The radiological differential diagnosis of spinal cystic tumor includes a cystic neurinoma, ependymoma, neurenteric cyst, epidermoid, bronchogenic cyst, cystic teratoma, Tarlov cyst, and arachnoid cyst 3) 4)

A contrast study is preferred to differentiate schwannoma from other neoplasms. Rim enhancement of an intradural extramedullary tumor on MRI should be considered as the diagnosis of schwannoma.

1)
Matsui H, Kanamori M, Yudoh K, Ohmori K, Yasuda T, Wakaki K. Cystic spinal cord tumors: magnetic resonance imaging correlated to histopathological findings. Neurosurg Rev 1998; 21: 147-151.
2)
Jaiswal A, Shetty AP, Rajasekaran S. Giant cystic intradural schwannoma in the lumbosacral region: a case report. J Orthop Surg (Hong Kong) 2008; 16: 102-106.
3)
Kasliwal MK, Kale SS, Sharma BS, Suri V. Totally cystic intradural extramedullary schwannoma. Turk Neurosurg 2008; 18: 404-406.
4)
Shiono T, Yoshikawa K, Iwasaki N. Huge lumbar spinal cystic neurinomas with unusual MR findings. AJNR Am J Neuroradiol 1995; 16 (4 Suppl): 881-882.