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Spinal Cord Astrocytoma — SCE Neurology MCQ

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HardNeuro-oncologySpinal Cord AstrocytomaSCE Neurology

A 45-year-old woman presents with a 1-year history of progressive right upper and lower limb weakness and spasticity. MRI spine shows an intradural, intramedullary enhancing lesion at C5–C7 with surrounding cord oedema. The lesion is solid and heterogeneously enhancing. She has no other neurological history. What is the most likely diagnosis?

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Correct answer: E — Spinal cord astrocytoma

The best answer is “Spinal cord astrocytoma”. Neuro-oncology management depends on anatomical compartment, histology, molecular classification, growth, neurological deficit and resectability, with specialist multidisciplinary planning. The alternatives “Spinal meningioma”, “Spinal ependymoma”, “Neurofibroma”, “Metastatic deposit” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG99 brain tumours and metastases recommendations: https://www.nice.org.uk/guidance/ng99/chapter/Recommendations