Incidental discovery of an intradural extramedullary tumor during imaging studies of a traumatic injury at the same spinal level: a case report

SUMMARY A 72-year-old man with a history of fall was admitted to our institute. Neurological testing demonstrated motor weakness of left upper limbs, showing grade 3/5 muscle strength for wrist and fingers. He had no sensory loss in his trunk or bilateral upper and lower extremities. Deep tendon reflexes were normal in both upper and lower extremities. Babinski signs were positive bilaterally. Radiologic examination showed fractures of cervical spine at the C3 and C6 levels which we classified as stage 3 compressive flexion fractures under the Allen classification system. Magnetic resonance imaging （MRI） showed a space-occupying lesion in the vertebral canal at the C3/4 level. We initially diagnosed the mass as a traumatic spinal subdural or subarachnoid hematoma. Diachronic MRI evaluation and enhanced-MRI and CT myelogram established the diagnosis of an intradural extramedullary tumor. To the best of our knowledge, no report has previously described finding an intradural extramedullary tumor incidentally during imaging studies of a traumatic injury at the same spinal level. Our experience suggests that the presence of atypical findings, such as oval shape, in a posttraumatic space-occupying spinal lesion should lead clinicians to consider the possibility that the lesion may be a tumor rather than a hematoma.