Prevalence: 25–45% of all spine tumors; 2–3% of pediatric spinal tumors; 12% of all meningiomas

Age:>40 years + female (80%)

Location: thoracic region (82%); cervical spine on anterior cord surface near foramen magnum (2^nd most common location); 90% on lateral aspect

Site: intradural extramedullary (50%); entirely epidural; intradural + epidural

• spinal cord / nerve root compression
• bone erosion in <10%
• scalloping of posterior aspect of vertebral body
• widening of interpedicular distance
• enlargement of intervertebral foramen
• may calcify (not as readily as intracranial meningioma)

CT:

• solid smoothly marginated mass isodense with skeletal muscle
• marked enhancement

MR:

• isointense with spinal cord on T1WI + T2WI
• ± dural tail reflecting tumor spread / reactive changes
• rapid + intense enhancement after Gd-DTPA

DDx: nerve sheath tumor