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Primary atypical sacral meningioma--not always benign
A K Bhadra1, A T H Casey, A Saifuddin
1Royal National Orthopaedic Hospital, Stanmore, London, UK. arupbhadra@yahoo.com
Skeletal Radiology
|November 11, 2006
Summary
This case study details an atypical meningioma of the sacrum in a young man, which recurred locally and metastasized to the lungs, leading to a fatal outcome.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Meningiomas are typically benign tumors arising from the meninges.
- Atypical meningiomas (WHO Grade II) exhibit increased cellularity and mitotic activity, suggesting higher recurrence risk.
- Sacral meningiomas are rare, particularly atypical variants with metastatic potential.
Observation:
- A 31-year-old male presented with sacral pain and urinary hesitancy.
- Initial MRI revealed a sacral canal lesion consistent with meningioma.
- Histological examination confirmed an atypical meningioma.
Findings:
- The patient experienced local recurrence of the atypical meningioma twice after surgical excision.
- Metastatic disease to the lungs was identified after the second recurrence.
- The patient succumbed to a chest infection 18 months after initial diagnosis.
Implications:
- This case highlights the aggressive nature of atypical sacral meningiomas, even in young patients.
- Recurrent and metastatic meningiomas pose significant management challenges.
- Early detection and aggressive treatment strategies may be crucial for improving outcomes in rare, aggressive meningioma cases.
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