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KMID : 0388720230300040125
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Journal of Korean Society of Spine Surgery
2023 Volume.30 No. 4 p.125 ~ p.130
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Extra-Intradural Thoracic Spinal Meningioma Mimicking a Malignancy: A Case Report and Literature Review
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Bae Ji-Ho
Song Sang-Youn
Song Myung-Geun
Kim Dong-Hee
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Abstract
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Study design: Case report.
Objectives: To report a case of a 65-year-old male patient with an extra-intradural thoracic spinal meningioma mimicking a malignancy.
Summary of Literature Review: In cases of extra-intradural meningioma, which could be misdiagnosed as a metastatic tumor, if it is difficult to differentiate the tumor through preoperative imaging, the diagnosis must be made through an intraoperative frozen biopsy.
Materials and Methods: A 65-year-old man visited our outpatient clinic with paraparesis and paresthesia of 2 months’ duration. A radiologic evaluation at a district hospital revealed L2 and L3 spinal stenosis. He underwent L2 to L3 posterior lumbar interbody fusion and L3 laminectomy. The patient’s symptoms were not relieved after operative treatment. A repeated radiologic evaluation revealed a 1.9-cm mass with rim enhancement in the spinal canal at the T9 to T10 level, extending into the left T9-10 foramen. A routine radiologic evaluation showed a 2.3-cm incidental ground glass opacity in the right upper lobe, which mimicked malignant metastasis.
Results: The patient underwent T9-10 level laminectomy and tumor removal, as well as T7-8 and T11-12 level posterior fusion.
Meningioma was confirmed based on histological testing conducted using tissue obtained from the extra-intradural area. His lower limb motor power gradually improved to grade IV for both hip flexion and extension two months after surgery.
Conclusions: Because it is challenging to distinguish the tumor using preoperative imaging techniques, a definitive diagnosis should be established via intraoperative frozen biopsy.
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KEYWORD
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Extra-intradural, Spinal meningioma, Cord compression, Metastasis
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