A 55 year old female with 2 years history of back ache with 6 months history of paresthesia in both legs with radicular pain and right leg weakness followed by left leg weakness after 2 months. The weakness gradually progressed so that for last 20days patient is unable to walk with diminished sensation below the level of lower abdomen.No h/o fever, weight loss, night pain or history of TB. On examination spastic paraparesis with sensory involvement without bladder and bowel involvement. No spinal tenderness. MRI spine posted below. Differentials?

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Gradually progressive etiology Slowly growing tumor vs Potts spine Rules out Conus medullaris since no bladder and asymmetric to begin with.

do pet scan to rule out melignency
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Dumb bell shaped tumor suggestive of neurofibroma causing extramedullary intradural compressive myelopathy

Neurofibroma

It's neurofibroma... Please give images Other sequences

Sorry , i have taken only these two photos
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PARAPARESIS DUE TO PID&DISCPROLAPSE.

Schwannoma vs Meningioma.. Intradural Extramedullary mass..

Exclude tb. Abscess at T5....6 .. spine. Or fnac with ct guide at same level . Neuro surgical opinion.

Dumbbell shaped tumor more in favor of neurofibroma or Schwannoma dd 1.ganglioneuroma 2.meningioma 3.paraganglionoma

Neurofibroma

Neurofibroma