[Thoracic intramedullary neurinoma with multiple intracranial meningiomas; case report]

A 42-year-old man suffered from numbness in his right leg in May, 1989, and was admitted to another hospital for examination. Computed tomography and magnetic resonance imaging revealed thoracic intramedullary tumor and multiple intracranial tumors in the right frontal convexity, the right lower surface of the tentorium and the right parietal parasagittal region. In December, he underwent craniotomy and the right frontal tumor was totally removed. It was diagnosed histologically as meningioma. Because of continuing numbness in his right leg, he visited a neurologist at our university and was referred to us for removal of the spinal tumor on April 25, 1990. Neurological examination on admission revealed mild weakness of his right leg and exaggerated right knee jerk. Though he complained of numbness in his right leg, no sensory disturbance was demonstrated objectively. His bladder-bowel function was normal. There were no café au lait spots or subcutaneous neurofibromas. He and his mother were positive for anti-HTLV-1 (human T-lymphotrophic virus type 1) antibody. On May 1, laminectomy was performed at Th-7 to Th-9, and a yellowish brown tumor was found occupying the right posterolateral portion of the cord and extending to the surface. The dorsal root of Th-9, which was involved in the tumor, was cut and the tumor was subtotally removed. Histological examination showed interlacing bundles of spindle cells and loose areolar region. Immunohistochemically, the tumor was positive for S-100 protein and negative for GFAP. From these findings, the tumor was diagnosed as neurinoma. The postoperative course was uneventful, numbness disappeared, and the patient was discharged without neurological deficits.