Unusual appearance of an en plaque  meningioma of the cervical spinal canal.     A case report and literature review.
METHODS
A case report of a patient with cervical spinal cord and nerve root compression caused by a meningioma en plaque together with calcification of the posterior longitudinal ligament is presented,with a review of the literature.


OBJECTIVE
To present the diagnosis of a calcified dural meningioma en plaque, with extradural extension into the ligamentum flavum, in a woman with cervical myelopathy and neuropathy.


BACKGROUND
This case demonstrates that the cervical spine can be involved in dural meningioma en plaque with calcifications, in a manner mimicking ossification of the ligamentum flavum, which has never been previously reported.


METHODS
A patient presenting with cervical cord and nerve root compression caused by ossification of the posterior longitudinal ligament and a concurrent calcified dural meningioma en plaque was treated surgically and has made a gradual recovery. Imaging studies,surgical findings, and histopathologic evaluation were analyzed to support the diagnosis.


RESULTS
At surgery, ossification of the posterior longitudinal ligament was noted, along with a calcified lesion involving the posterior cervical dura and the adjacent ligamentum flavum. A calcified meningioma was diagnosed by histopathologic examination of the dural-based lesion.


CONCLUSIONS
Although previously not described, the diagnosis of calcified dural meningioma en plaque should be considered in all patients presenting with spinal cord and/or nerve root compression,even at cervical levels. Although ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum are more common etiologies of partially circumferential spinal calcification, dural-based meningiomas with extension into the surrounding ligaments demand early recognition because they can be associated with a poorer prognosis.
Gamache
F W
FW
Department of Surgery (Division of Neurosurgery),New York Presbyterian Hospital-Weill Medical Collegeof Cornell University and Neuroscience Institute523 East 72nd Street, New York, NY 10021, USA.
Wang
J C
JC
Deck
M
M
Heise
C
C
D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008579:Meningioma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D017887:Ossification of Posterior Longitudinal Ligament / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed