Extradural cervical spinal meningioma without myelopathy

Only 2.5-3.5% of all spinal meningiomas are extradural.

A 45-year-old female presented with chronic neck pain and bilateral arm numbness but was otherwise neurologically normal. The cervical magnetic resonance (MR) imaging revealed a right-sided extradural extramedullary lesion extending from C5 to C7. Through a C4-C7 laminectomy, the patient underwent subtotal tumor excision; the intracanalicular portion of the tumor was excised, leaving behind some extraforaminal components. The histopathology was consistent with a typical meningioma (i.e., containing meningothelial cells and psammomatous calcifications).

Extradural cervical spinal meningiomas are rare. Following MR studies, patients may undergo routine dorsal resection of the intracanalicular components of the meningioma, leaving behind extraforaminal extension if warranted. Early recognition and treatment lead to the most favorable outcomes.