J Korean Soc Spine Surg.  2019 Sep;26(3):100-104. 10.4184/jkss.2019.26.3.100.

A Rare Extradural Spinal Meningioma with Nocturnal Chest Pain: A Case Report

• Kim SB
• Won Y
• Jang MG
• Min YK
• Gutzeit A
• Casari F
• Hausmann O

• KMID: 2459759
• DOI: http://doi.org/10.4184/jkss.2019.26.3.100

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
To report a rare case of a spinal extradural meningioma in a patient with longstanding nonspecific thoracic nocturnal pain. SUMMARY OF LITERATURE REVIEW: Meningioma is a frequent intradural extramedullary tumor that is associated with pain, sensory/motor deficits, and sphincter weakness. Spinal meningiomas most commonly occur in the thoracic spine, although they can also be found at other locations.
MATERIALS AND METHODS
A 65-year-old woman first visited the cardiac and gastrointestinal departments of our institution due to chest pain 2 years previously. No explanation for the complaint could be found in the heart or other organs. On a computed tomography scan of the thorax, a spinal mass was found a few months before the diagnosis. On magnetic resonance imaging, an extramedullary and extradural mass was observed at T7/8.
RESULTS
We performed surgery and found an extradural spinal meningioma upon the histological diagnosis. Postoperatively, the patient could adequately move both legs and feet and the nocturnal chest pain disappeared after surgery without any complications.
CONCLUSIONS
Awareness of the rarity and nonspecific symptoms of extradural spinal meningiomas will be beneficial for their accurate diagnosis and proper treatment.

Keyword

Extradural space; Thoracic pain; Iatrogenic dural injury; Spinal meningioma; Spine tumors

MeSH Terms

Aged
Chest Pain*
Diagnosis
Female
Foot
Heart
Humans
Leg
Magnetic Resonance Imaging
Meningioma*
Spine
Thorax*

Figure

• 

  Fig. 1. Sagittal T1-weighted (T1W), T2-weighted (T2W), and T1 fat-suppressed and gadolinium-containing contrast-enhanced magnetic resonance imaging scan. (A) T1W image showing an isointense extradural lesion at the T8 level. (B) T2 fat-suppressed image showing a hypointense lesion. (C) T1 gadolinium-containing contrast-enhanced image showing an extradural lesion with some heterogeneity, but mostly a hyperintense signal.

• 

  Fig. 2. Sagittal T1-weighted image showing an isointense extradural lesion on T8, mainly on the right side. The lesion extended along the fora-men.

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  Fig. 3. Axial T1-weighted fat-suppressed gadolinium-containing contrast-enhanced magnetic resonance imaging scan showing an extradural lesion with some heterogeneity, but mostly a hyperintense signal at T8. The mass on the right side was pushing the cord to the left.

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