Spinal Schwannomatosis Mimicking Metastatic Extramedullary Spinal Tumor

Intradural extramedullary (IDEM) tumors are the most commonly observed intraspinal tumors, comprising over 60% of tumors found within the spinal canal, and the vast majority of these lesions are benign lesions. IDEM metastases are rare, but if they occur, they commonly manifest as leptomeningeal disease, secondary to drop lesions from intracranial metastases from adenocarcinomas of the lung, prostate cancer, breast cancer, melanoma, or rarely, as a result of lymphomas. The purely non-neurogenic origin of IDEM metastases is rare. Herein, we describe a patient with a previous history of treated colon cancer who presented with a progressive neurological deficit and whose imaging revealed multiple intradural, extramedullary and osseous lesions at the cervical and thoracolumbar spines. With the previous known primary and multiplicity of the lesions, an initial diagnosis of spinal metastasis was made, But it was proven to be schwannoma on histology. We emphasize the diagnostic dilemma in this case and the importance of detecting subtle imaging findings, which may be helpful to differentiate between metastatic disease and a second primary tumor

A Comparison of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and T2-Weighted Imaging in Determining the Depth of Myometrial Invasion in Endometrial Carcinoma—A Retrospective Study

This study aims to compare dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with T2-weighted imaging (T2WI) in defining the depth of myometrial invasion in endometrial carcinoma. This retrospective study included 32 subjects with endometrial carcinoma who underwent 3.0T magnetic resonance imaging (MRI) prior to hysterectomy. DCE-MRI and T2WI were evaluated to determine the depth of myometrial invasion in endometrial carcinoma. A set of data consisting of the sensitivity, specificity, predictive values, and accuracy of DCE-MRI and T2WI were obtained and compared with the histopathological results. Out of the 32 cases included, the histopathological examination revealed that 50% myometrial invasion was found in 11 patients and ≥50% myometrial invasion was found in 21 patients. In the assessment of the tumor invasion, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of T2WI were 45.45%, 90.48 %, 71.43%, 76.0%, and 75.0%, respectively. The corresponding values for DCE-MRI were 81.82%, 76.19%, 64.29%, 88.89 %, and 78.12%, respectively. When T2WI were read together with DCE-MRI, the values were 90.91%, 90.48%, 83.33%, 95.0%, and 90.62%, respectively. Thus, the sensitivity and accuracy of DCE-MRI were greater compared to T2WI in defining the depth of myometrial invasion. However, the merging of T2WI and DCE-MRI increased the specificity and PPV value and improved the sensitivity, NPV and accuracy in detecting myometrial invasion. DCE-MRI was more sensitive but less specific than T2WI in defining the depth of myometrial invasion. In conclusion, combining DCE-MRI and T2WI further improves the diagnostic performance for myometrial invasion in endometrial carcinoma