Pilocytic Astrocytoma, WHO Grade I, conus medullaris. 74 yo F.

Findings:

Multiple MR images show a complex cystic and solid heterogeneously enhancing mass involving the conus, associated with a complex syrinx containing hemorrhagic products. A multilevel laminectomy defect is noted in this region.

Differential Diagnosis:

Ependymoma, Astrocytoma, less likely hemangioblastoma or metastatic disease.

Discussion:

-proven histologically

-not all tumors follow the rules

-astrocytoma more typically infiltrative with solid enhancement, upper cord, younger age group, no syrinx, no hemorrhage

-ependymoma commonly in older age group, syrinx, hemorrhage

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