Can Yaldiz, Kiyasettin Asil, Davut Ceylan and Sahin Erdem
Background Context: Thoracic involvements of meningiomas are rarely seen and only a couple of dumbbellshaped meningiomas are reported in the literature. Spinal meningiomas (SM) consist of 25% of all spinal masses. Most of the SMs are intradural. Less than 10% have extradural extension.
Purpose: Pure spinal extradural meningiomas (SEM) are seen so rare. We are reporting the 7th case of meningioma with dumbbell-appearance located in the cervicothoracal region.
Methods: 48 years old female patient who has no known disease before she has referred to our clinic with complaints of pain, feeling of numbness at the right arm, shoulder and the back that she has been suffering for 6 months. In the neurological examination of the patient, hypoesthesia has seen under the level of Th1. Deep tendon reflexes of the lower extremities (DTR) were observed to be suspicious bilaterally in respect to hyperactivity. In the spinal magnetic resonance imaging (MRI) of the patient), after Gadolinium infusion of the mass involving the epidural area in the spinal channel of the bone between C7 vertebra and T2 vertebrae, resulting in dumbbell appearance, a lesion with homogenous contrast enhancement was observed.
Results: T1 total laminectomy was applied to the patient. The mass found in the extradural region and extending to the apex of the right lung was totally removed with micro chirurgical method. Pathology of the mass was reported as psammomatous meningioma. The patient was discharged at the post-operative 3rd day without an additional neurologic deficit.
Conclusion: Though extradural spinal meningiomas are rarely seen, since they imitate spinal metastatic masses, should be kept in mind in the differential diagnosis. Surgery should be the first treatment of choice.
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