67-year-old woman with history of upper abdominal pressure, incidental spinal mass found on pelvic MRI. Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is significant dextroscoliosis of the lumbar spine and mild levoscoliosis of the lower lumbar spine. Bone marrow signal is heterogeneous but benign. The conus medullaris is normal in position.At the right posterolateral T12 level (1202/40) there is a 13 x 13 x 12 cm homogenously enhancing, T1 and T2 isointense, round intradural, extra medullary lesion. This lesion displaces the conus to the left and has mass effect with flattening of the distal cord. There are subtle calcifications noted corresponding to this lesion on the CT from 2/2013. No additional abnormal enhancing foci are identified.Multilevel degenerative changes are seen, as described below:T12-L1: Disc osteophyte complex is present and there appears to be moderate narrowing of the left neural foramen. No right neural foraminal or spinal canal stenosis.L1-L2: Disc bulge is present and there is marked left facet joint arthropathy with thickening of the ligamentum flavum. There is moderate narrowing of the left neural foramen. No significant spinal canal or right neural foraminal stenosis.L2-L3: Disc bulge is present and there is bilateral facet joint arthropathy with ligamentum flavum hypertrophy. There is partial effacement of the left lateral recess, mild to moderate narrowing of the left neural foramen, and fairly mild narrowing of the right neural foramen. No spinal canal stenosis.L3-L4: There is bilateral facet joint arthropathy, right greater the left, with ligamentum flavum hypertrophy. There is partial effacement of the right lateral recess and mild narrowing of the bilateral neural foramina. There is mild central spinal canal stenosis.L4-L5: There is bilateral facet joint arthropathy, right greater the left, with ligamentum flavum hypertrophy. There is partial effacement of the right lateral recess and moderate narrowing of the right neural foramen. No significant left neural foraminal stenosis. There is mild central spinal canal stenosis.L5-S1: There is mild bilateral facet joint arthropathy and an eccentric right disc bulge with a small central protrusion. There is no significant neural foraminal or spinal canal stenosis, but there is contact of the disc with the extraforaminal right nerve root.Mildly complex renal cysts partially visualized bilaterally. Large fibroid uterus partially visualized.
1.Extramedullary-intradural enhancing mass in the posterolateral spinal canal at T12 with imaging features favored to represent meningioma. Nerve sheath tumor is an additional consideration. 2.T12 lesion causing moderate to severe spinal canal stenosis including mass effect on the conus.3.Scoliosis, moderate degenerative changes of the lumbar spine, and multifocal neural foraminal stenoses as described above without associated high-grade spinal stenosis.