Case 6: 30-year-old man without VHLD.
A and B, Sagittal T1-weighted SE images (400/23/2) before (A) and after (B) intravenous administration of contrast material show a large, sausagelike, well-demarcated, intensely but heterogeneously enhancing tumor at T12–L1. Note superficial enhancement of the spinal cord (arrows, B), confirmed to be dilated perimedullary veins at surgery. Cephalic portion of the tumor resides within the spinal cord, and the caudal portion is extramedullary. A large intramedullary tumor with exophytic growth was confirmed at surgery.
C, Sagittal T2-weighted FSE image (4000/96/3) shows mixed hyper- and isointense tumor. Cephalic to this tumor is syringomyelia up to C2 level (only partially shown). Note prominent vascular flow voids (arrows).
D and E, Arterial (D) and venous (E) phases of digital subtraction angiograms, anteroposterior view, with right T10 intercostal artery catheterized, show intense tumor stain at T12–L1, dilated posterior spinal artery as a feeder (straight arrows, D), and dilated draining vein (curved arrows, E).