Nguyen Bao Quoc, Tran Duc Duy Tri, Dang Thuan Cong, Mai Thi Dang, Pham Hai Duong, Truong Van Tri
Department of Neurosurgery, Hue University Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Department of Histology, Embryology, Pathology and Forensic Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Surg Neurol Int. 2021 Sep 6;12:454. doi: 10.25259/SNI_615_2021. eCollection 2021.
Most spinal meningiomas primarily grow in the intradural extramedullary location. Epidural meningiomas are uncommon; if detected, they usually coexist with intradural lesions. They inhere more aggressive and invasive characteristics compared with their counterparts inside the dura.
We report a 22-year-old female who was admitted to the hospital with weakness and numbness in both lower limbs. Her cervical magnetic resonance imaging revealed an en-plaque and dumbbell-shaped lesion located from C5 to C8. After gadolinium injection, the whole mass was enhanced and unveiled two portions: intradural and extradural. The bone window of the computed tomography scan revealed calcification inside the lesion. The patient underwent tumor removal surgery. The pathology findings showed a psammomatous meningioma. After 6 months of surgery, the patient has been able to walk with walkers.
We should consider spinal meningioma as a differential diagnosis when encountering an extradural lesion in the cervical region. The optimal surgical treatment for young patient with epidural meningiomas is radical surgery with dura attachment removal.
大多数脊膜瘤主要生长于硬脊膜内髓外位置。硬膜外脊膜瘤并不常见;若被发现,通常与硬脊膜内病变共存。与硬脊膜内的同类肿瘤相比,它们具有更强的侵袭性。
我们报告一名22岁女性,因双下肢无力和麻木入院。她的颈椎磁共振成像显示一个从C5至C8的斑块状哑铃形病变。注射钆剂后,整个肿块强化,显示出硬膜内和硬膜外两部分。计算机断层扫描的骨窗显示病变内有钙化。患者接受了肿瘤切除术。病理结果显示为砂粒体型脊膜瘤。手术后6个月,患者已能借助助行器行走。
遇到颈椎区域的硬膜外病变时,我们应将脊膜瘤作为鉴别诊断之一。对于年轻的硬膜外脊膜瘤患者,最佳的手术治疗方法是彻底切除肿瘤并去除与硬脊膜的附着处。