Cervical extradural meningioma: case report and literature review
Brian L Frank1, James S Harrop, Amgad Hanna
1Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Background:
Extradural lesions are most commonly metastatic neoplasms. Extradural meningioma accounts for 2.7 to 10% of spinal neoplasms and most commonly is found in the thoracic spine.
Design:
Case report.
Findings:
A 45-year-old woman presented with posterior cervicothoracic pain for 8 months following a motor vehicle crash. Magnetic resonance imaging of the cervical spine revealed an enhancing epidural mass. Computerized tomography of the chest, abdomen, and pelvis revealed no systemic disease. Due to the lesion's unusual signal characteristics and location, an open surgical biopsy was completed, which revealed a psammomatous meningioma. Surgical decompression of the spinal cord and nerve roots was then performed. The resection was subtotal due to the extension of the tumor around the vertebral artery.
Conclusion:
Meningiomas should be considered in the differential diagnosis of contrast-enhancing lesions in the cervical spine.
Insights
This case report highlights a rare psammomatous meningioma in the cervical spine. Early consideration of meningiomas is crucial for diagnosing spinal cord lesions.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Extradural lesions are typically metastatic neoplasms.
- Extradural meningiomas represent a small percentage (2.7-10%) of spinal neoplasms, predominantly in the thoracic region.
Observation:
- A 45-year-old woman experienced cervicothoracic pain post-motor vehicle accident.
- Cervical spine MRI showed an enhancing epidural mass; systemic disease was ruled out by CT scans.
Findings:
- Open surgical biopsy confirmed a psammomatous meningioma due to unusual characteristics and location.
- Subtotal tumor resection was performed due to vertebral artery involvement, following spinal cord decompression.
Implications:
- Meningiomas should be included in the differential diagnosis for cervical spine contrast-enhancing lesions.
- This case underscores the importance of considering rare diagnoses in spinal epidural masses.
