Spinal meningioma - densely calcified

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Progressive lower limb weakness.

Patient Data

Age: 70 years
Gender: Female

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 tumor 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 tumor 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.

Histology

MICROSCOPIC DESCRIPTION: The sections show a moderately hypercellular meningioma of  psammomatous type. Tumor cells between psammoma bodies have regular  nuclear features. No mitotic figures or areas of necrosis are seen. 

FINAL DIAGNOSIS:  Spinal meningioma. 

Case Discussion

Spinal meningiomas can on occasion be densely mineralized / calcified and extend through the neural exit foramen. 

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