A case of cervical epidural meningioma with atypical image findings

Spinal extradural meningiomas are rare and must be distinguished from malignant tumors due to their invasive nature and intense activity. We report a case of a cervical epidural meningioma presenting with atypical imaging findings.

A 51-year-old woman presented with progressive paresis in both the upper and lower limbs. Magnetic resonance imaging revealed an extradural lesion at the C2-C4 level with homogeneous contrast enhancement. The lesion extended from the intervertebral foramen into the posterior cervical musculature. Computed tomography demonstrated diffuse calcification, spanning from the spinal canal to the posterior cervical musculature. The patient underwent tumor resection and decompression surgery, which led to an improvement in her neurological symptoms. Pathological examination confirmed the diagnosis of a psammomatous meningioma.

Cervical epidural meningiomas are extremely uncommon, and differential diagnosis can be challenging, especially in cases involving invasion into the posterior cervical muscles and calcification. Severely invasive lesions are often difficult to resect completely and necessitate careful follow-up.