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Multiple meningiomas of the spinal canal and posterior fossa--case report
Abstract:
The majority of multiple meningiomas are associated with von Recklinghausen's disease, and those that are not, i.e., true multiple meningiomas, particularly with simultaneous development in the posterior fossa and spinal canal, are very rare. We recently encountered a case of true multiple meningiomas in which the lesions were found simultaneously in the left posterior fossa and the upper thoracic spinal canal. The spinal meningioma consisted mainly of meningotheliomatous components, and that in the posterior fossa of fibroblastic components. Both tumors were surgically removed. The cause of the multiplicity in cases of true multiple meningiomas is unknown. Incidental multiplicity is a consideration when the number of tumors is relatively small. Spinal meningiomas are often undetected in the absence of neurological symptoms. However, even if von Recklinghausen's disease is not present, and particularly when more than two meningiomas have been discovered, the patient must be carefully examined for other tumors.
Insights
True multiple meningiomas, especially those occurring simultaneously in the posterior fossa and spinal canal without von Recklinghausen's disease, are exceptionally rare. This case highlights the importance of thorough examination for additional tumors in such instances.
Area of Science:
- Neurosurgery
- Oncology
- Pathology
Background:
- Multiple meningiomas are typically associated with neurofibromatosis type 1 (von Recklinghausen's disease).
- True multiple meningiomas, occurring independently of genetic syndromes, are rare.
- Simultaneous occurrence in distinct locations like the posterior fossa and spinal canal is exceptionally uncommon.
Observation:
- A rare case of true multiple meningiomas was identified.
- Lesions were simultaneously present in the left posterior fossa and the upper thoracic spinal canal.
- Histological examination revealed distinct components: meningotheliomatous in the spinal tumor and fibroblastic in the posterior fossa tumor.
Findings:
- The patient presented with two distinct meningiomas without evidence of von Recklinghausen's disease.
- Surgical removal of both tumors was successfully performed.
- The etiology of tumor multiplicity in sporadic cases remains unknown.
Implications:
- This case underscores the rarity of true multiple meningiomas with simultaneous posterior fossa and spinal involvement.
- It emphasizes the need for vigilant screening for additional meningiomas, even in the absence of neurofibromatosis type 1, particularly when multiple lesions are detected.
- Early detection of spinal meningiomas, often asymptomatic, is crucial for timely intervention.