Yokosako Suguru, Hirasawa Motohiro, Kubota Yuichi
Department of Neurosurgery, Tokyo Women's Medical University Adachi Medical Center, Adachi-Ku, Japan.
Department of Spine and Spinal Surgery, Tokyo Shinagawa Hospital, Shinagawa-Ku, Japan.
Surg Neurol Int. 2025 Feb 7;16:33. doi: 10.25259/SNI_1124_2024. eCollection 2025.
Spinal extradural meningiomas are rare and must be distinguished from malignant tumors due to their invasive nature and intense activity. We report a case of a cervical epidural meningioma presenting with atypical imaging findings.
A 51-year-old woman presented with progressive paresis in both the upper and lower limbs. Magnetic resonance imaging revealed an extradural lesion at the C2-C4 level with homogeneous contrast enhancement. The lesion extended from the intervertebral foramen into the posterior cervical musculature. Computed tomography demonstrated diffuse calcification, spanning from the spinal canal to the posterior cervical musculature. The patient underwent tumor resection and decompression surgery, which led to an improvement in her neurological symptoms. Pathological examination confirmed the diagnosis of a psammomatous meningioma.
Cervical epidural meningiomas are extremely uncommon, and differential diagnosis can be challenging, especially in cases involving invasion into the posterior cervical muscles and calcification. Severely invasive lesions are often difficult to resect completely and necessitate careful follow-up.
脊柱硬膜外脑膜瘤较为罕见,因其具有侵袭性和高活性,必须与恶性肿瘤相鉴别。我们报告一例具有非典型影像学表现的颈椎硬膜外脑膜瘤病例。
一名51岁女性出现双上肢和双下肢进行性无力。磁共振成像显示C2 - C4水平硬膜外病变,呈均匀强化。病变从椎间孔延伸至颈后肌肉组织。计算机断层扫描显示从椎管至颈后肌肉组织弥漫性钙化。患者接受了肿瘤切除减压手术,术后神经症状有所改善。病理检查确诊为砂粒体性脑膜瘤。
颈椎硬膜外脑膜瘤极为罕见,鉴别诊断具有挑战性,尤其是在病变侵犯颈后肌肉和出现钙化的情况下。侵袭性强的病变往往难以完全切除,需要密切随访。