Cervical spinal meningioma mimicking intramedullary spinal tumor.
METHODS
Case report.


OBJECTIVE
To report a very unusual spinal meningioma, mimicking an intramedullary spinal tumor.


BACKGROUND
Spinal meningiomas, usually associated with signs and symptoms of cord or nerve root compression, are generally encountered in women aged over 40. Radiologic diagnosis is often established by their intradural extramedullary location on magnetic resonance images.


METHODS
A 60-year-old woman had a 6-month history of progressive weakness in her upper extremities, difficulty in walking, and cervical pain radiating through both arms. Neurologic examination revealed motor strength deficiency in all her extremities, with extensor reflexes, clonus, and bilateral hyper-reflexiveness. A sensory deficit was present all over her body. Magnetic resonance images revealed that the spinal cord appeared expanded with an ill-defined, homogeneously contrast-enhanced, lobulated, eccentric mass at the C1-C3 level. The patient was operated with a preliminary diagnosis of an intramedullary tumor.


RESULTS
At surgery, the mass was found to be extramedullary, and gross total resection was performed. Histopathological examination revealed a meningioma characterized by the presence of fibrous and meningothelial components. The patient was able to ambulate with a cane, and extremity strength and sensation improved 2 months after surgery.


CONCLUSIONS
Spinal meningiomas can mimic intramedullary tumors, and should be considered in differential diagnosis of intradural tumors with atypical appearance.
Senturk
Senem
S
Department of Radiology, Dicle University School of Medicine, Diyarbakir, Istanbul, Turkey. ssenturk@dicle.edu.tr
Guzel
Aslan
A
Guzel
Ebru
E
Bayrak
Aylin Hasanefendioğlu
AH
Sav
Aydin
A
D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000473:pathology