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Updated: Sep 13, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Extra-intradural Spinal Meningioma: A Case Report
Seong Kyun Jeong1, Han Yu Seong1, Sung Woo Roh1
1Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract:
Extradural spinal meningiomas are uncommon, and their pathophysiology is not entirely understood. Here, we present the case of a 49-year-old woman with low back and left leg pain of 5 years duration. Magnetic resonance imaging revealed a mass, 1.8-cm in size, with rim enhancement in the spinal canal at the T12 level and extending into the left T12-L1 foramen. In the surgical field, the mass presented with the characteristics of an extra-intradural spinal meningioma. The patient underwent a T12 total laminectomy. A linear durotomy was performed at the midline, and the intradural portion was removed. The extradural portion was not separable from the adjacent dura and the left T12 root, and it was removed by dural excision. Pathological examination confirmed the diagnosis of psammomatous meningioma. We also conducted a literature review of similar cases. Based on our experience with this case, we believe that it is important to clearly distinguish extradural meningiomas from other types of tumors as misdiagnosis can change the operative plan. The long term prognosis of extradural meningiomas is not clear but total excision is thought to be essential.
Insights
Extradural spinal meningiomas are rare tumors. This case highlights the importance of accurate diagnosis for surgical planning and emphasizes total excision for better outcomes in managing these challenging spinal neoplasms.
Area of Science:
- Neurosurgery
- Spinal Oncology
- Pathology
Background:
- Extradural spinal meningiomas are uncommon tumors with unclear pathophysiology.
- These tumors can present with symptoms such as low back and leg pain.
Purpose of the Study:
- To present a case of an unusual extra-intradural spinal meningioma.
- To emphasize the importance of distinguishing extradural meningiomas from other spinal tumors for surgical planning.
Main Methods:
- Case presentation of a 49-year-old woman with a T12 level spinal mass.
- Magnetic resonance imaging (MRI) for diagnosis.
- Surgical removal including T12 total laminectomy, durotomy, and dural excision.
- Pathological examination confirming psammomatous meningioma.
Main Results:
- A 1.8-cm mass with rim enhancement was identified at the T12 level, extending into the T12-L1 foramen.
- The mass had both extra-intradural components, requiring complex surgical resection.
- Pathology confirmed a psammomatous meningioma.
Conclusions:
- Accurate differentiation of extradural meningiomas is crucial to avoid misdiagnosis and guide operative strategy.
- Total excision is considered essential for the long-term prognosis of extradural meningiomas, although long-term outcomes remain unclear.
