title: Totally extradural spinal en plaque meningiomas - Diagnostic dilemmas and treatment strategies.
abstract: BACKGROUND
  Meningiomas are the second most common intraspinal tumors, constituting ~25% of all intraspinal tumors; however, in the context of extradural spinal lesions, the diagnosis of meningioma is an uncommon one. Purely extradural spinal meningiomas, especially of the en plaque variety, frequently mimic metastatic disease and may result in inadequate therapy.
  
  
  METHODS
  We report two cases of totally extradural en-plaque meningiomas of the spine, one each in the cervical and dorsal spine. We present the significant diagnostic dilemmas posed by these cases and discuss the pathogenesis, treatment strategies, and long-term behavior of these uncommon lesions.
  
  
  CONCLUSIONS
  Attention needs to be drawn to this dangerous preoperative and intraoperative misinterpretation. Intraoperative histopathology support for correct identification, gross total resection at surgery, inclusion of a durotomy to rule out intradural extension, and long-term follow-up are cornerstones for successful management of totally extradural en plaque spinal meningiomas.
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Amey
authors.initials: A
authors.lastname: Savardekar
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Debarshi
authors.initials: D
authors.lastname: Chatterjee
authors.affiliation: Department of Pathology, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Debajyoti
authors.initials: D
authors.lastname: Chatterjee
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Sivashanmugam
authors.initials: S
authors.lastname: Dhandapani
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mohindra
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical education and Research, Chandigarh, India.
authors.forename: Pravin
authors.initials: P
authors.lastname: Salunke
keywords: En plaque meningiomas; extradural spinal lesions; spinal meningiomas