Radiology Quiz 19731 | Radiopaedia.org

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Findings

What the is the postulated mechansim for the development of dumbbell or extradural meningiomas?

Meningiomas probably pass out of the dura through (or in the case of purely extradural tumours originate in) arachnoid villi / granulations present where never roots exit the dura [1-3].

Question 2

What is the surgical management of dumb-bell tumours?

Show Answer

Typically requires the intraspinal and paraspinal components to be tackled, either as a two stage or single stage operation, consisting of both laminectomy and costotransversectomy [3]. In this case, as there is no paraspinal component (only a foraminal one) the tumour may be completely excised via a laminectomy only.

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

Histology

MICROSCOPIC DESCRIPTION: Paraffin sections show a moderately hypercellular meningioma with a well developed syncytial architecture. Scattered calcified psammoma bodies are also noted. Tumour cells have uniform nuclear features. No mitotic figures or areas of necrosis are identified. Extension into the cortex of bone is noted.

FINAL DIAGNOSIS: spinal tumour: meningioma.