Journal List > J Korean Radiol Soc > v.23(3) > 1065585

Lee, Lee, and Chang: Radiologic evaluation of spinal epidural mass

Abstract

It is often difficult to differentiate each pathologic entity among various spinal epidural masses on theradiologic basis. We retrospectively analysed radiologic findings of 67 cases of pathologically proven spinalepidural mass to find out any speicfic findings of each epidural mass. The results are as follows: 1. Of 67 cases,metastasis(16 cases), epidural abscess(15 cases), neurogenic tumor(16 cases) and meningioma(8 cases) are mostcommon/ the others consist of epidural angioma(3 cases), vertebral hemangioma(2 cases), chondrosarcoma(2 cases),fibrosarcoma(1 case), eosinophilic granuloma(1 case), lymphoma(1 case), lipoma(1 case) and lymphoid hyperplasia(1case). 2. Destruction of the adjacent bone was commonly associated with the epidural mass in metastasis(75%) andepidural abscess(67%). It was also noted in 2 cases of chondrosarcoma, 1 fibrosarcoma and 1 eosinophilicgranuloma. 3. Pressure erosion of adjacent bone was demonstrated inn neurogenic tumor(75%) and meningioma(25%). 4.Narrowing of intervertebral space was seen in only 27% of epidural abscess. 5. The paraspinal tumor was associatedin 67% of meastasis,80% of epidural abscess, 75% of neurogenic tumor, 33% of meningioma. It was also seen in 2cases of chondrosarcoma, 1 fibrosarcoma and 1 eosinophilic granuloma. 6. The intradural tumor was associated inn50% of neurogenic tumor and 67% of meningioma. 7. On axial CT image, most of the epidural mass shows eccentriclocation with displacing dural sac to the opposite side. The diseases that occasionally show encircling locationare metastasis, epidural abscess, vertebral hemangioma, chondrosarcoma, eosinophilic granuloma, and lymphoma.Neurogenic tumor only shows multicentric location. 8. The disease extent more than height of one vertebral body was seen in 80% of epidural abscess, 58% of neurogenic tumor, 100% of epidural angioma. It was also seen in 2cases of chondrosarcoma, 1 fibrosarcoma, 1 eosinophilic granuloma, 1 lymphoma, 1 lipoma and 1 lymphoidhyperplasia. But the extent less than height of one vertebral body was demonstrated in 67% of metastasis, 50% ofmeningioma and 1 vertebral hemangioma.

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