A vividly enhancing intramedullary mass is located at T6 occupying almost the entire spinal canal. It is associated with extensive high T2 signal within the cord extending to the mid-cervical cord and down to the level of T9. At the level of T4 a small focal syrinx is present.
In addition to the vividly enhancing component, both above and below it is intramedullary curvilinear enhancement with matching T2 signal loss suggestive of vessels. Superficial enhancement probably representing engorged leptomeningeal veins rather than leptomeningeal deposits although the latter is certainly a possibility.
Conclusion: The lesion almost certainly represents a tumour, and in the absence of known metastatic disease, presumably a primary tumour of the spinal cord. Prominent vessels suggests that this is a haemangioblastoma, although other entities could have a similar appearance (e.g. ependymoma - although lacking peritumoral cysts or haemosiderin capping; diffuse astrocytoma - usually enhancement is less intense and circumscribed; primary CNS lymphoma - although usually is of lower T2 signal).