This is a 35 year old formerly athletic woman with chronic lower back pain
IMG 1 of 3

IMG 2 of 3

IMG 3 of 3

Diagnosis: Myxopapillary ependymoma

Differential Diagnosis:

• Ependymoma
• Schwannoma
• Drop metastasis
• Dermoid
• Ganglioglioma
• Paraganglioma

IMG 1 of 3

Findings:

• T2 weighted sagittal and axial MR images of the lumbar spine show an intradural, intramedullary mass below a normally located   conus. The lesion has intrinsic T2 hyperintensity superiorly and is hypointense inferiorly. The lower portion of the lesion enhances following gadolinium administration 
• Myxopapillary ependymomas are almost exclusively located in the filum terminate or conus medullaris. They are typically well circumscribed lesions that often contain hemorrhage. Typical MR imaging appearance is isointensity on T1 weighted images and hyperintensity on T2 weighted images, with intense enhancement post gadolinium administration. Necrosis and cystic degeneration may occur adding to signal heterogeneity