Calcifying pseudoneoplasm of the spine

Calcifying pseudoneoplasms have been rarely reported to involve the spine. Diagnostically, MRI characteristics have not been well-described. We present the case of a 59-year-old woman with a C8 radiculopathy and history significant for metastatic breast cancer. MRI showed a C7-T1 extradural mass with an isointense signal to the spinal cord on T1- and T2-weighted sequences. Mild peripheral enhancement was also noted. The patient underwent a laminectomy to accomplish resection of the underlying lesion. The mass was firm, tan-colored, and adherent to the adjacent dura. A gross total resection was achieved and, postoperatively, the patient had resolution of her radiculopathy. Pathologic analysis confirmed a calcifying pseudoneoplasm. Calcifying pseudoneoplasms can cause exclusively axial pain or may induce radicular or myelopathic symptoms. The pathogenesis is unclear, although the lesions are usually benign. MRI findings can vary, but typically the lesions are extradural, well-demarcated, and mildly enhance peripherally. Surgical resection, either subtotal or total, is highly successful.