Figure 2

Magnetic resonance imaging (MRI) scan of the lumbar spine eight months after the onset of symptoms. T2-weighted (A) and T1-weighted (B-C) images before and after contrast administration show mild contrast enhancing multilobular tumors in the epidural fat behind the dural sac at the level of L3-L4 (black arrows) and a dural sac filled with intradural tumors (white arrows). Note the absence of the normal cerebrospinal fluid signal in the dural sac below the medullary conus. Axial T1-weighted images before (D) and after (E) contrast administration show the epidural metastases lateral and dorsal to the dural sac (black arrows in D; arrowheads in E). The white arrow in E shows the dorsal limit of the dural sac. F) Axial T1-weighted image after contrast administration shows a tumor-filled dural sac (white arrows).