title: Spinal tumors in patients with neurofibromatosis type 2: MR imaging study of frequency, multiplicity, and variety.
abstract: OBJECTIVE
  Neurofibromatosis type 2 (NF2) is a rare autosomal dominant disorder leading to various tumors of the CNS, with vestibular schwannomas being the hallmark of the disease. We have observed multiple asymptomatic spinal lesions in patients who have a single symptomatic spinal tumor. Accordingly, we studied the frequency, multiplicity, and variety of spinal tumors in all patients with NF2 to determine what is characteristic of the disease.
  
  
  METHODS
  MR images of the entire spinal canal were made in 73 patients aged 4-69 years with NF2. The number, location, morphology, signal characteristics, and contrast medium uptake of the spinal tumors as seen on MR images were recorded and analyzed. Histopathologic proof of 22 spinal tumors was obtained in 19 patients.
  
  
  RESULTS
  Spinal tumors were found on MR images in 89% of the patients studied. No location in any part of the spine was preferred. MR imaging showed intramedullary tumors in 24 patients (33%) (three ependymomas pathologically proven). Extradural and intradural extramedullary tumors were found on MR imaging in the cervical spine of 36 patients, the thoracic spine of 40 patients, and the lumbar spine of 49 patients. These tumors were meningiomas, schwannomas, or neurofibromas, three categories that could not be differentiated on the basis of the neuroradiologic findings, with ten schwannomas, seven meningiomas, and two neurofibromas pathologically proven. Extradural extramedullary tumors were found on MR imaging in the cervical spine of 12 patients, the thoracic spine of five patients, and the lumbar spine of 18 patients. A syrinx associated with a tumor was found in two patients. In 19 patients the variety of tumor types was confirmed by histologic examination.
  
  
  CONCLUSIONS
  Patients with NF2 frequently have spinal tumors, which are often multiple and of various histologic types. The presence of multiple and different pathologic types of spinal tumors is highly suggestive of NF2.
authors.affiliation: Department of Neurology, Allgemeines Krankenhaus Hamburg Ochsenzoll, Germany.
authors.forename: V F
authors.initials: VF
authors.lastname: Mautner
authors.forename: M
authors.initials: M
authors.lastname: Tatagiba
authors.forename: M
authors.initials: M
authors.lastname: Lindenau
authors.forename: C
authors.initials: C
authors.lastname: Fünsterer
authors.forename: S M
authors.initials: SM
authors.lastname: Pulst
authors.forename: M E
authors.initials: ME
authors.lastname: Baser
authors.forename: L
authors.initials: L
authors.lastname: Kluwe
authors.forename: F E
authors.initials: FE
authors.lastname: Zanella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis*; D016518:Neurofibromatosis 2 / Q000175:diagnosis*; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000473:pathology