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Sofia Bettencourt1, Pedro Brandão1, Gonçalo Lobo1, Mariana Baptista1, Carla Conceição1

1 - Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

- 45th ESNR Annual Meeting, 14-18 Setembro, Lisboa
- Neuroradiology (2022) 64 (Suppl 1):S1-S165

Introduction: Spinal tumours are rare, being responsible for 5-10% of all CNS tumours. They can be divided according to their topographic location as arising extradurally, intradural-extramedullary or intramedullary. Intradural extramedullary tumours are responsible for 70-80% of all spinal tumours, with schwannoma and meningioma being the most frequent ones. However, other noteworthy, less common neoplasms must be considered when evaluating this compartment. The most frequent complaint of patients with intradural extramedullary tumours is axial back pain, which may be non-specific. Radicular pain can also affect these patients, particularly those with nerve sheath tumours. If there is spinal cord compression myelopathy or cauda equina syndrome can occur. Usually, these are slow-growing tumours, and there can be a delay of several months before a radiological diagnosis is established. 
Method: We retrospectively collected multiple cases of intradural extramedullary spinal tumours and provide a pictorial review depicting the key clinical and imaging findings that can help narrow the differential diagnosis.
Result: In our series, we describe seven different cases of intradural extramedullary spinal tumours, including a poorly differentiated carcinoma metastasis, one hemangioblastoma, one spinal ependymoma, one lipoma, a disseminated glioneuronal tumour with spinal drop metastasis, and also a schwannoma and a meningioma.
Conclusion: Imaging , particularly MRI is a cornerstone in the diagnosis of intradural extramedullary tumours, evaluating its morphologic and signal characteristics, enhancement pattern and tumour extension. Since prompt treatment is essential for preventing the progression of neurological deficits and allowing symptomatic relief, the knowledge of the clinical background and the distinct imaging characteristics of the neoplasms that may affect this region can help narrow the differential diagnosis.

Keywords: spine, spinal tumours, MR imaging, intradural extramedullary tumour, poorly differentiated carcinoma metastasis, hemangioblastoma, spinal ependymoma, lipoma, disseminated glioneuronal tumour with spinal drop metastasis, schwannoma, meningioma