Aunt Mickeys are alternative diagnoses for “Aunt Minnies”. They represent less common diagnoses, and emphasize the importance of clinical history and careful imaging review.
Dumbell spinal mass: Nerve sheath tumor or something completely different?
A “dumbell” spinal mass was discovered during CT angiographic evaluation of an aortic aneurysm in this 66-year-old female. She had experienced constant but stable low back pain. There were no neurologic deficits.
The lesion was biopsied under CT guidance. At pathology, the lesion was composed of closely apposed small to medium sized blood vessels (some of which contained organizing thrombus) without intervening stroma. The vessels were admixed with fibroadipose tissue. The pathological diagnosis was “hemangioma” (a misnomer, as these lesions represent venous vascular malformations, not true hemangiomas). More detailed review of the imaging study revealed several findings that might have suggested this pathologic possibility.
