Epidural Spinal Mass

Differential considerations for epidural masses include:

• Degenerative: Disc herniation, facet osteophytosis, ligamentum flavum hypertrophy, synovial cyst, ossification of the posterior longitudinal ligament
• Epidural lipomatosis: Prominent epidural fat. Seen with prolonged steroid administration or Cushing syndrome. Y-shaped configuration of thecal sac on axial images is characteristic.
• Fluid collections: Pseudomeningocele, hematoma, abscess, arachnoid cyst.
• Metastasis: The lesion shown here ended up being Ewing sarcoma.
• Lymphoma
• Nerve sheath tumors: Nodular, fusiform, or dumbbell-shaped mass associated with nerve roots.