Ho Ue-Cheung, Chang Koping, Lin Yen-Heng, Huang Yu-Cheng, Tsuang Fon-Yih
Division of Neurosurgery, Department of Surgery, and.
Departments of Pathology and.
J Neurosurg Case Lessons. 2021 Oct 18;2(16):CASE21362. doi: 10.3171/CASE21362.
Primary intraosseous meningiomas (PIMs) are rare, and PIMs of the vertebrae have not yet been reported. The authors report a case of primary meningioma arising from the vertebrae.
A 49-year-old man presented with lower back pain and numbness in both lower extremities. Lumbar spine magnetic resonance imaging revealed an L2 pathological fracture with epidural and paraspinal invasion. The patient had undergone a first palliative decompression and fixation surgery, and the diagnosis turned out to be a World Health Organization grade III anaplastic meningioma based on histopathology. The tumor had progressed after first operation and radiation therapy, and the patient was referred to the authors' institute for excision. The patient had an uneventful postoperative course after a revisional total en bloc spondylectomy of L2.
The authors present a rare case of PIM of the vertebrae with epidural and paraspinal invasion. Careful preoperative assessment and surgical planning is crucial for successful patient management.
原发性骨内脑膜瘤（PIM）较为罕见，尚未有关于椎体PIM的报道。作者报告一例起源于椎体的原发性脑膜瘤病例。
一名49岁男性出现下背部疼痛和双下肢麻木。腰椎磁共振成像显示L2病理性骨折伴硬膜外及椎旁侵犯。患者曾接受首次姑息性减压固定手术，根据组织病理学诊断为世界卫生组织III级间变性脑膜瘤。首次手术及放疗后肿瘤进展，患者被转至作者所在机构进行切除。患者在L2椎体翻修整块切除术后恢复顺利。
作者报告了一例罕见的伴有硬膜外及椎旁侵犯的椎体PIM病例。术前仔细评估和手术规划对患者的成功管理至关重要。
