Spinal meningioma (L3/4)

Case contributed by A.Prof Frank Gaillard



Patient Data

Age: 50 years
Gender: Female

A well circumscribed vividly enhancing eccentric intrathecal extra-medullary mass is present, displacing the cauda equina to the left, and compressing it. On both T1 and T2 weighted images it is isointense to cord. 

Case Discussion

The patient went on to have resection. 



The sections show a moderately cellular tumour. The tumour forms sheets and nests in a fibrous background. No whorls are seen. The tumour cells have round hyperchromatic nuclei, inconspicuous nucleoli and moderate amounts of clear cytoplasm. There is no nuclear pleomorphism. Mitoses are inconspicuous. There is no necrosis. The tumour cells are focally PAS positive. They are EMA and progesterone receptor positive. The Ki-67 index is about 8%. They are CAM5.2 and CD10 negative. The features are those of clear cell meningioma, which

is classified as WHO grade II.


L3/4 spinal tumour: Clear cell meningioma (WHO Grade II).


The signal intensity similar to cord on T2 is helpful in suggesting the diagnosis of meningioma over a schwannoma or myxopapillary ependymoma despite the somewhat atypical location. 

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Case information

rID: 31238
Published: 27th Dec 2014
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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