Meningioma thoracic spine
Back pain and weakness in lower limbs.
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There is an intra dural extra medullary mass with epicentre at the level T10 -11 intervertebral disc which demonstrates homogeneous enhancement following contrast administration, except for a well defined focus of non- enhancement in the left side of the lesion. This same area returns low signal on all sequences provided; it probably represents a focus of scarring, haemosiderin or calcium.
The mass does not extend into neural foramen and no definite dural tail. The mass displaces the to the left and significantly compresses the thoracic cord. At the level of the superior endplate T11 there is complete effacement of CSF in the thecal sac. There is increased signal in the cord superior to the compressed segment.
Conclusion: Intradural extramedullary mass. The differential is essentially between a meningioma and a schwannoma. In this demographic and location a meningioma is more likely.
The patient went on to have resection.
MICROSCOPIC DESCRIPTION: Sections show syncytial cells forming whorls together with multiple psammomatous calcifications. Tumour cells contain pale eosinophilic cytoplasm, oval nuclei with bland chromatin and small nucleoli. No necrosis or mitoses are seen. There is no evidence of atypia or malignancy.
FINAL DIAGNOSIS: Spinal meningioma (WHO grade I)