Differential diagnosis of pediatric spinal canal lesions

• Astrocytoma of spinal cord
• Ependymoma of spinal cord
• Ganglioglioma of spinal cord
• Schwannoma of spinal nerve
• Neurofibroma of spinal nerve
• Meningioma of spinal nerve
• Drop metastases to spinal cord
• Neuroblastoma
• Disc herniation
• Bone tumors
• Epidural abscess
• Epidural hematoma

Approach to the differential diagnosis of spinal canal lesions:

• Intramedullary lesion – looks like a snake swallowing an egg: astrocytoma, ependymoma, ganglioglioma
• Extramedullary intradural lesion – looks like a turtle on a table due to CSF capping: schwannoma, neurofibroma, meningioma, drop metastasis (medulloblastoma, ependymoma, germinoma, choroid plexus tumor, pineal tumors)
• Extramedullary extradural lesion – looks like a dog under a rug due to epidural fat capping: neuroblastoma, disc herniation, bone tumors, epidural abscess, epidural hematoma