Spinal meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Progressive spacticity.

Patient Data

Age: 80 years
Gender: Female
MRI

 

The abnormality is a large extramedullary intradural mass at T1 level markedly compressing the spinal cord. It shows homogeneous enhancement, heterogeneous high-signal on the T2-weighted sequence and measures 22 x 12 mm in cross-section, 23 mm in length. The rest of the spinal cord is unremarkable. Minimal extension through the left C7-T1 neural foramen.

The intervertebral discs are diffusely desiccated, with osteochondral bars in the mid cervical segment causing minor canal stenosis without spinal cord compression. Moderate bilateral foraminal stenosis at C4-5 to C6-7 levels from uncovertebral osteophytes.

Conclusion:

Severe spinal cord compression at T1 by large left spinal canal mass consistent with meningioma. A nerve sheath tumour is in the main differential diagnosis.

Case Discussion

The patient went on to have a resection, which confirmed the diagnosis of a spinal meningioma . 

Histology

Paraffin sections show a moderately hypercellular meningioma. This has a well-developed syncytial architecture. Many calcified Psammoma bodies are also present. Tumour cells have uniform nuclear features. No mitotic figures or areas of necrosis are seen. Dural attachment is noted.

Final diagnosis: Meningioma (WHO Grade I - transitional / mixed histology).

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Case information

rID: 41940
Case created: 29th Dec 2015
Last edited: 19th Aug 2017
Inclusion in quiz mode: Included

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