title: Epidural meningioma of the sacral canal. Case report.
abstract: Spinal meningiomas are reported infrequently as pure epidural tumors, and they are rarely located at the caudal end of the spine. The unique combination of a wholly epidural tumor confined entirely to the sacral canal has not been previously described. The authors describe the case of a 29-year-old man who presented with coccygeal and left-sided S2-4 dermatomal pain. Examination confirmed sensory loss in the same distribution. A magnetic resonance image revealed an enhancing mass lesion in the sacral canal scalloping the bone at S-2 and S-3. An apparent complete resection was performed. Intraoperatively the authors observed an entirely epidural tumor with a small dural attachment at the most caudal end of the thecal sac. Histological examination confirmed that the tumor was an atypical meningioma. A local recurrence developed within 1 year of surgery, and the patient underwent a hemisacrectomy for tumor removal. An additional recurrence in the lumbosacral spine and multiple pulmonary metastases developed thereafter. In addition to the unique nature of this case, the authors also observed a tumor behaving in a far more aggressive fashion than its histological findings would suggest. This adds to the differential diagnosis of tumors occurring in the sacral canal.
authors.affiliation: Department of Neurosurgery, Hope Hospital, Salford, Manchester, United Kingdom. scott.rutherford@srht.nhs.uk
authors.forename: Scott A
authors.initials: SA
authors.lastname: Rutherford
authors.forename: Kim M
authors.initials: KM
authors.lastname: Linton
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Durnian
authors.forename: Richard A
authors.initials: RA
authors.lastname: Cowie
mesh_terms: D000328:Adult; D004824:Epidural Space / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008579:Meningioma / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011379:Prognosis; D012445:Sacrococcygeal Region; D013120:Spinal Cord Neoplasms / Q000473:pathology* / Q000601:surgery