Ossified extradural en-plaque meningioma of the cervical spine. (April 2018)

• Record Type: Journal Article
• Authors: Sakamoto, Koichiro; Tsutsumi, Satoshi; Nonaka, Senshu; Suzuki, Takamoto; Ishii, Hisato; Ito, Masanori; Yasumoto, Yukimasa
• Is Part Of: Journal of clinical neuroscience. Volume 50(2018)
• Page Start: 124
• Page End: 126
• Publication Date: 2018-04
• Subjects: Spinal extradural meningioma -- En plaque -- Ossification -- Surgery; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.01.058
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Spinal epidural meningioma (SEM) is a rare, but distinct entity. En-plaque appearance and calcifications are characteristic appearance of SEM. A 57-year-old woman sustained an en-plaque SEM in the lower cervical spine. The tumor was highly fibrous with ossified core and severe adherence to the dura. Ossification may be a pathognomonic appearance of SEM, making resection difficult. Abstract: A 57-year-old woman sustained gradually progressive sensorimotor disturbance in the left upper extremity for one year. Neurological examination found a diminished sensation below the left C7 dermatome and reduced strength in the left interosseous muscles. Computed tomography of the cervical spine revealed a high density mass at C7, in the left dorsal part of the spinal canal. Magnetic resonance imaging found an enhancing, en-plaque tumor at C6-T1, involving a non-enhancing part, and considerable compression of the spinal cord. The patient underwent tumor resection through hemilaminectomy of C5-C7. The tumor was located epidurally, highly fibrous including bony-hard parts, and severely adhered to the dura mater that necessitated drilling for debulking. A subtotal resection was achieved and histological diagnosis was a fibrous meningioma with metaplastic ossification. Ossification may be a pathognomonic appearance of spinal extradural meningiomas that makes resection maneuvers difficult.