Intramedullary gliofibroma: MR, ultrasound, and pathologic correlation

We describe the clinical, MR, ultrasound, and pathologic findings of an intramedullary gliofibroma. This uncommon primitive tumor is thought to be of mixed glial and mesenchymal origin. Although the majority of tumors described to date have been histologically benign, clinical course has been quite variable. On MRI, the tumor we report was isointense to adjacent spinal cord on T1-weighted imaging and became hyperintense on proton and T2-weighted imaging. Enhancement with gadolinium diethylenetriamine pentaacetic acid was mild and slightly heterogeneous. Intraoperative ultrasound demonstrated widening of the lower thoracic cord. Echo pattern was generally similar to that of adjacent cord. The major differential diagnostic considerations include astrocytoma and ependymoma.