Meningioma - spinal

Case contributed by Dr Ammar Haouimi

Presentation

Monoparesis of the left lower limb.

Patient Data

Age: 55 years
Gender: Male
MRI

There is a small well-circumscribed intradural extramedullary mass at T5-T6 level of posterolateral location. It appears of intermediate signal intensity on T1WI, and T2WI with homogeneous enhancement following IV contrast. The adjacent segment of the spinal cord is compressed and displaced to the right. No evidence of broad-based dural attachment or dural tail sign.

A well-defined area of high signal intensity on T1WI, and T2WI of C2 vertebral body, extending to the left pedicle, attenuated on STIR sequence, most likely a fatty vertebral hemangioma (less likely to be intraosseous lipoma).

Case Discussion

MRI features highly suggestive of spinal meningioma.

Around 80% of the spinal meningiomas are located in the thoracic region, and often of posterolaterally location (as in this case). The differential diagnosis should include the neurogenic tumors (spinal schwannoma and spinal neurofibroma).

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