Multinodular and Vacuolating Neuronal Tumor–like Lesion of the Spinal Cord: Two Case Reports

Case 1; 45-year-old woman A, Sagittal TSE T2-weighted image shows a multilocular intradural intramedullary lesion. There are multiple cystic-like changes within the spinal cord at different levels of the cervicothoracic junction. Note that there is neither syringomyelia nor T2-hypointense changes within the medulla. A cervical disk extrusion at C6–C7 can also be seen. B, Sagittal TSE T1-weighted image after the intravenous administration of gadolinium. No contrast enhancement can be seen. C, Sagittal echo-planar diffusion-weighted image shows no diffusion restriction within the lesion. D, Para-axial gradient recalled-echo T2-weighted image depicts the cystic-like intra-axial lesion. Note the sharp delineation of the lesions without perilesional edema. These lesions are located within the white matter of the spinal cord, without affecting the gray matter. E, Sagittal FLAIR T2-weighted image shows the T2-hyperintense lesion. Unlike perivascular spaces (also called Virchow-Robin spaces), there is no signal loss on FLAIR. F, Sagittal short tau inversion recovery T2-weighted image from a 12-month follow-up. No alterations in signal intensity or morphology were detected. Stable lesion.