What is the differential for an intramedullary enhancing spinal cord mass?
Glial neoplasms (spinal ependymoma, spinal astrocytoma, spinal ganglioglioma), non-glial neoplasms (spinal haemangioblastoma, intramedullary metastasis, lymphoma), spinal cord abscess, demyelination.
The well defined 1 cm ovoid intra-medullary lesion located just above the conus at the level of T12-L1 shows ring enhancement post contrast. There is associated mild expansion. The predominantly central, markedly hyperintense signal on T2 weighted scans without corresponding axial T1 hypo-intensity seen within conus and extending superiorly to the distal thoracic cord up to the level of T2 is also associated with mild cord expansion. The cervical cord is spared allowing for 3T artefact. No abnormal flow voids or enhancing vessels around the cord. No definite abnormal leptomeningeal enhancement.
A spiculated mass measuring up to 3 cm in the right upper lobe of lung. A 5 mm nodule is also present in the left upper lobe of lung.