Clinical History: A 59 year old male patient presented with back pain radiating to left lower limb since few years. Prior X rays did not reveal any abnormality. Patient referred for imaging of L-S Spine.
Imaging Findings: On CT scan , there was a lesion eroding the borders of the left neuroforamen and especially the posterior contour of the L4 vertebral body. There was marked rim sclerosis around the lesion indicating a non-aggressive lesion.MRI performed subsequently showed a T2-hyperintense, somewhat heterogeneous lesion along the left L4 traversing nerve root,protruding in to the superior part of the L4-L5 neural foramen on the left side. On T1WI images, the lesion was completely isointense to muscle. On post contrast the lesion enhanced avidly. Retrospectively,X ray L-S spine revealed defect in the L4 vertebral body on the left side with non visualisation of the left pedicle.
Final Diagnosis: Schwannoma (Neurilemmoma)