Workup/Staging

Question 1

What is the most common presenting Sx of primary SC tumors, and over what timeframe do Sx present?

Answer 1

Pain (75%), with Sx presenting over mos to yrs (long prodrome)

Question 2

What is particularly important as part of the workup for an SC tumor?

Answer 2

Detailed neurologic exam and SC imaging (MRI with contrast)

Question 3

What is the difference b/t astrocytomas and ependymomas on MRI (location/appearance)?

Answer 3

Astrocytoma: T1: iso/hypointense, T2: hyperintense, T1 C+: majority patchy enhancement, eccentric/asymmetric expansion of SC

Ependymoma: T1: iso/hypointense, mixed if cyst/hemorrhage, T2: hyperintense, peritumor edema, T1 C+: almost all enhance, central/symmetric expansion of SC

Question 4

What is the MRI appearance of SC lipomas?

Answer 4

Bright on T1 without contrast, and signal disappears on fat suppression.

Question 5

Which primary SC tumors require imaging of the entire craniospinal axis?

Answer 5

Ependymomas, GBM, and anaplastic astrocytomas