Today’s Interesting Case: A Smile in Contrast

Mar 5, 2015

Radsource radiologists are constantly communicating and sharing knowledge with each other. In our blog series Today’s Interesting Case, our team will post notable cases and images for discussion from time to time. 

 

In our case today, a 21 year-old female presents with a 2 month history of neck pain and right arm radiculopathy.

intraforaminal mass

 

 

A T1-weighted sagittal image demonstrates an extramedullary, intraspinal mass towards the right at C5. Congenital fusion of C3 and C4 is also present.

 

 

 

 

 

 

intraforaminal mass

 

 

The lesion extends into the right neural foramen and markedly flattens the cord, as seen on this T2-weighted axial view.

 

 

 

 

 

 

 

 

The location of this lesion and the MR signal characteristics are highly suggestive of a schwannoma.  So far, this is simply a typical appearance of this type of intraforaminal mass.

Today’s case is interesting primarily because of this next image, though.

intraforaminal mass

 

 

Following contrast administration, intense heterogeneous enhancement results in an unusual, smiley-face appearance.  This image was too fun not to share!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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