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Spinal meningioma

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Progressive lower limb weakness.

Patient Data

Age: 50 years
Gender: Female
mri

A homogeneously enhancing intra-dural, extramedullary mass with a broad dural base, dural tail and in the vertebral canal anteriorly at the level of T1 is demonstated. It results in significant cord compression with flattening of the cord and obliteration of the CSF space. The cord is displaced posterolaterally to the right. Mild associated cord signal hyperintensity is observed. 

Normal bone marrow signal. Multiple endplate focal compression fractures consistent with Schmorl's nodes.

Annotated image

Extradural mass ( * ) with dural tail extending above and below it (yellow arrows) results in marked compression of the upper thoracic cord (dotted blue line). 

The patient went on to have a laminectomy and excision of the mass. 

Histology

MICROSCOPIC DESCRIPTION:    The sections show a moderately cellular meningioma with adjacent fibrous tissue and nerve bundles.  The tumor comprises whorls. The  tumor cells have ovoid nuclei but with no nuclear pleomorphism.   Mitoses are inconspicuous.  There is no necrosis. Occasional tumor  nests are seen within nerve fibers. There is no malignant change.   

FINAL DIAGNOSIS:  Meningioma (WHO I) 

Case Discussion

Typical appearances of a spinal meningioma, with elegant demonstration of a dural tail.

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