Spinal meningioma (densely calcified - foraminal)
Progressive lower limb weakness.
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Densely calcified extradural mass to the left of midline is identified within the thoracic spine spanning the T3 and upper half of the T4 vertebral levels. Maximal vertical dimension of the tumour measures 2.9 cm. The meningioma produces mass effect on the spinal cord with displacement to the right which is maximal at the T3 level. The lesion extends to and just crosses midline to the right within the canal. The tumour fills and expands the left exit foramen at the T3/4 level with extension into the paravertebral tissues laterally by 0.6 cm.
Hyperdense material and some locules of gas are appreciated within the soft tissues overlying the upper thoracic back. The superior level of these changes is aligned with the tip of the T3 spinous process, and extends inferiorly to the level of the T4 spinous process.
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MICROSCOPIC DESCRIPTION: The sections show a moderately hypercellular meningioma of psammomatous type. Tumour cells between psammoma bodies have regular nuclear features. No mitotic figures or areas of necrosis are seen.
FINAL DIAGNOSIS: Spinal meningioma.
Spinal meningiomas can on occasion be densely mineralised / calcified and extend through the neural exit foramen.