J Korean Soc Radiol.  2018 Jul;79(1):11-17. 10.3348/jksr.2018.79.1.11.

Spinal Extradural Meningioma: A Case Report and Review of the Literature

• Hong W
• Kim ES
• Lee Y
• Lee K
• Koh SH
• Song H
• Kwon MJ

• KMID: 2416400
• DOI: http://doi.org/10.3348/jksr.2018.79.1.11

Abstract

Spinal meningiomas account for 12% of all the meningiomas and are usually located in the intradural extramedullary space. In some cases, they are associated with some extradural extensions. However, purely extradural spinal meningiomas are rare. Additionally, it is difficult to make an accurate preoperative diagnosis. We report a case of pathologically confirmed atypical meningioma, presented as a posterior epidural mass on the thoracic spine. We review the case, clinical symptoms, radiologic findings and the histologic features.

MeSH Terms

Adult
Diagnosis
Epidural Space
Humans
Meningioma*
Spine

Figure

• 

  Fig. 1 MRI and pathologic findings of spinal extradual meningioma in a 58-year-old woman who has progressive weakness of both lower legs for 4 months. A, B. The T1-weighted image (A) and the T2-weighted image (B) display the posterior epidural mass with a similar signal intensity to the spinal cord. The subarachnoid space is obliterated at the level of the mass and the spinal cord is compressed. The dura mater is seen as a dark line (arrows) separating the extradural mass from the intradural structures. Elevated signal change, within the compressed spinal cord, represents compressive myelopathy on the T2-weighted image (B). C, D. Contrast-enhanced sagittal (C) and axial (D) T1-weighted images depict strong and homogeneous contrast enhancement of the posterior epidural mass (arrows). Note the complete filling of the posterior epidural space and the extension to the left neural foramina of the vertebrae (D). E. Histologically, the tumor was dominated by multiple vessels (arrowheads) interspersed with small meningothelial tumor cells (arrows) and focal necrosis (hematoxylin and eosin, × 100). F. Mitotic figures (arrows) are frequently identified, despite bland cytologic features of the tumor cells (hematoxylin and eosin, × 400).

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