Meningioma, Thoracic Spine

65-year-old female who presented for chronic lower back pain. The images demonstrate a well circumscribed, T1-isointense, T2/STIR-hyperintense mass with a focal avoid region of susceptibility and its inferior aspect within the upper thoracic spinal canal. The lesion is intradural but extramedullary. There is avid enhancement. The mass results in leftward displacement and effacement of the thoracic spinal cord with patchy STIR-hyperintense signal at that site. Imaging findings are most compatible with a meningioma at this site, though the differential includes peripheral nerve sheath tumor such as a schwannoma or neurofibroma. On resection, a meningioma was diagnosed. They are the second-most common intradural extramedullary spinal tumor. Peak incidence is in the fifth and six decades with females 10 times more commonly affected the males. Lesions are more common in patients with neurofibromatosis type II. The most common site of of involvement is the thoracic spine. Lesions are typically solitary, and treatment is with resection and/or radiotherapy.