title: Dumbbell-shaped meningioma with cystic degeneration in the thoracic spine: a case report.
abstract: METHODS
  A case report of dumbbell-shaped meningioma in the thoracic spine with cystic degeneration for which a combined posterior microscopic and anterior thoracoscopic approach was used is described.
  
  
  OBJECTIVE
  To report a rare case of dumbbell-shaped meningioma, and to describe a thoracoscopic surgical approach for paravertebral tumor.
  
  
  BACKGROUND
  Dumbbell-shaped tumors arising from nerve root sheaths are very common. However, a dumbbell-shaped meningioma is relatively rare, and reports on thoracoscopic resection of dumbbell and paravertebral tumors are still very few in number.
  
  
  METHODS
  The dumbbell meningioma was managed surgically. Because of the paravertebral tumor's intrathoracic expansion, a combined posterior and anterior approach was used. With the posterior approach, microscopic resection using hemilaminotomy was performed, whereas with the anterior approach, the thoracoscopic approach was used instead of thoracotomy.
  
  
  RESULTS
  Complete resection of the tumor was performed successfully. The patient regained his functional ability to walk soon after surgery because of less pain than with thoracotomy.
  
  
  CONCLUSIONS
  With combined microscopic and thoracoscopic surgery, dumbbell-shaped meningioma could be completely resected. The thoracoscopic approach for the removal of a paravertebral tumor can be a good alternative to thoracotomy.
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Suzuki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Sadahiko
authors.initials: S
authors.lastname: Konishi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamano
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed