Purely extradural spinal meningioma of the cervical spine: case report

초록

Objectives. To report a rare case of purely extradural spinal meningioma in a preoperative misdiagnosed patient to a metastatic lesion and to discuss the potential pitfalls in differential diagnosis of epidural masses. Background Data. Spinal meningiomas account for approximately 25% of all primary neoplasms of the spinal cord and spinal canal. Most spinal meningiomas are located in the intradural extramedullary space and extradural meningiomas are less common. they may easily be confused with malignant neoplasms that are much more common in epidural space. Extradural meningiomas are more aggressive than intradural ones, showing a more rapid course and more invasiveness. Methods. A 38-year old woman was referred to our hospital for the evaluation of 3-month-duration of neck pain and left side weakness. Magnetic resonance imaging scan revealed extradural spinal mass. Preoperative diagnosis was a metastatic neoplasm. Results. The purely extradural lesion was decompressed via a posterior approach. The intraoperative histologic diagnosis was a metastatic carcinoma. but, postoperative histologic examination revealed a meningotheliomatous meningioma. The patient is symptom free after surgery. Conclusion. Extradural spinal meningiomas are vary rare and may mimic metastatic disease. Tumor may be misinterpreted as a metastatic lesion and may be mistreated by a debulking procedure. Intraoperative and postoperative histology provide a optimal therapy.