L3 nerve root neuroma

Case contributed by Marina Goymer

Presentation

Abnormality seen on CT, for further assessment.

Patient Data

Gender: Female
MRI

L3 nerve root neuroma

There is a soft tissue mass just lateral to the left L3/4 foramen intimately associated with the L3 nerve root in the lumbar plexus.

The mass demonstrates high signal on T2-weighted sequences, and low signal on T1-weighted sequences.  There is a more fluid peripheral component with a solid central component and the lesion measures 2.0cm X 1.6cm X 1.7cm.

There is avid contrast enhancement of the central component.

These appearances are consistent with a nerve sheath tumor of the left L3 nerve root within the lumbar plexus in the medial aspect of the psoas muscle. The target appearance on T2 strongly favors a neurofibroma. 

Acquired on a 1.5T Toshiba Titan.

Case Discussion

The presence of a target sign is suggestive of a neurofibroma rather than a schwannoma or malignant peripheral nerve sheath tumor, but is unfortunately not pathognomonic. 

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Case information

rID: 28454
Published: 26th Mar 2014
Last edited: 14th Aug 2019
Tag: spine
Inclusion in quiz mode: Included

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