# Intravertebral collateral enhancement resembling sclerotic metastatic disease in a case of cervical epidural abscess

## TL;DR

A case is presented where spinal imaging showed signs similar to cancer spread, but it was actually due to an abscess, highlighting the need for careful diagnosis.

## Contribution

The paper reports a rare case of intravertebral enhancement mimicking metastasis without central venous obstruction.

## Key findings

- Vertebral enhancement can resemble sclerotic metastasis without underlying bone disease.
- The enhancement was linked to an epidural abscess, not central venous obstruction or cancer spread.
- This case emphasizes the importance of recognizing such imaging patterns to avoid misdiagnosis.

## Abstract

Vertebral body enhancement is occasionally seen on postcontrast CT imaging in the absence of osseous pathology. This enhancement can mimic sclerotic osseous metastatic disease, leading to a diagnostic dilemma for radiologists and increasing the chance of misinterpretation. Existing literature has focused on the association between this enhancement and concomitant central venous system obstruction. We report a 61-year-old woman with a history of nasopharyngeal carcinoma presenting with an epidural abscess who exhibited vertebral body enhancement resembling sclerotic metastatic disease without imaging evidence of central venous obstruction or vertebral osseous metastatic disease. Awareness of this unique presentation may prevent the incorrect diagnostic errors and their associated negative effects on patients.