Vol. 6, Issue 4, Part D (2020)

Case Report: We present a case of a 33-year-old male initially presented with bilateral sciatica and recumbent back pain. Mild urinary urgency for over last one month was also noted. MRI scan performed which demonstrated a homogenously enhancing intra dural, extra medullary nodule at the level L2 vertebral body. Radiologically this was interpreted as ependymoma versus meningioma. Neurosurgical consult recommended due to mass effect on the adjacent cauda equina nerve roots. Laminectomy was performed and excision was done of this space occupying lesion. The histopathology turned out to be paraganglioma versus neuroendocrine tumor.

Practical Implications: Paragangliomas and neuroendocrine tumors of spine are a rare entity. They can be misdiagnosed on imaging as they have similar or overlapping features of that of the meningioma or ependymoma. The purpose of this case report is to make radiologists aware regarding the rare entities come under differential diagnosis of intradural extra-medullary tumors. To a greater extent a combination of clinical, pathological and imaging correlation should be done for better diagnosis.