A 35 year-old woman presented with progressive quadriparesis, numbness of all four extremities and urinary incontinence over 6 weeks.

Sagittal MRI scan of the cervical and thoracic spine. (Left) T2-weighted image; (Middle) T1-weighted image; (Right) T1-weighted image with gadolinium. Note on the T2 sagittal scan, a large mass from C6-T2 that enhances with gadolinium (right image). In addition, both above and below the mass is a multi-loculated synrinx which appears very bright on T2 (i.e., signal c/w water). Lastly, note closely the cord at C1-C3, and below T7, there is edema from the lesion below. Neurosurgical exploration revealed a malignant intramedullary ependyoma.

Revised03/31/06.
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