Malignant intracranial meningioma with spinal metastasis--case report.
A 48-year-old woman presented with a left cerebellopontine angle mass. Over a 93-month period, the patient underwent seven surgeries, two radiosurgeries, and one external beam radiotherapy. The tumor was histologically benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery and demonstrated clinical characteristics of malignancy such as spinal metastasis. The patient underwent gamma knife radiosurgery (GKR) for recurrence after the first operation, despite the tumor being located in a resectable region. The tumor did not respond. Six months after the sixth surgery, the patient presented with progressive lower extremity paraparesis and sensory disturbance below the T11 dermatome. Magnetic resonance imaging revealed multiple intradural mass lesions located at the T2, T11-T12, and L2 levels. She died 4 months after the diagnosis of spinal metastases. Retrospectively, we speculate that if a tumor is located in a resectable region and Simpson grade I or II tumor resection is possible, direct surgery may be a safer option than GKR.
Kuroda
Hiroki
H
Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
Kashimura
Hiroshi
H
Ogasawara
Kuniaki
K
Sugawara
Atsushi
A
Sasoh
Masayuki
M
Arai
Hiroshi
H
Ogawa
Akira
A
D002471:Cell Transformation, Neoplastic / Q000528:radiation effects*; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008579:Meningioma / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards; D020335:Paraparesis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016634:Radiosurgery / Q000009:adverse effects* / Q000592:standards; D012086:Reoperation; D012189:Retrospective Studies; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology; D013120:Spinal Cord Neoplasms / Q000556:secondary*; D013346:Subarachnoid Space / Q000473:pathology / Q000503:physiopathology; D013904:Thoracic Vertebrae