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Myxopapillary Ependymoma

Paraganglioma

Nerve sheath tumor (schwannoma if hemorrhagic)

Mets.

#: 13% of all spinal ependymomas

Earlier clinical presentation (mean age, 35 years)

Distinct predilection for the conus medullaris or filum terminale

arise from the ependymal glia of the filum terminale.

most common neoplasm (83% of cases) in this region

Occasionally occur in the extradural space

arising from the coccygeal medullary vestige at the distal portion of the neural tube.

lobulated, soft, sausage-shaped masses

often encapsulated.

Typically T1 isointense and T2 hyperintense

Hyperintensity on both T1- and T2-weighted (occasionally)

reflects mucin content or hemorrhage

Superficial siderosis (occasionally)

not specific – seen with other vascular lesions

Enhancement (virtually always)

LOCATION at conus medullaris should suggest the diagnosis.