Non-Dural-Based Spinal Meningioma : The First Case Report of a Fibrous Subtype and a Review of the Literature

Abstract

Spinal meningiomas typically adhere to the dura matter. Non-dural based spinal meningiomas are rare and most are clear cell meningiomas. We report here the first case of a fibrous meningioma with non-dural attachment. The patient was a 49-year-old female, who complained of numbness in the legs and a gait disturbance. Magnetic resonance imaging revealed a 1.7×1.4-cm mass in the C7-T1 intra-dural extramedullary space, showing peripheral gadolinium enhancement without a "dural tail sign". A complete microsurgical resection was performed. The mass was covered with a white membrane but was not adhered to the dura, and its appearance was consistent with a neurilemmoma. The histopathological diagnosis was fibrous-type meningioma. The recovery of the patient was uneventful. No surgical complications and no recurrence of the tumor had occurred at the 6-month follow-up.

T2 Hypointense Schwannoma Masquerading As A Vascular Lesion: A Case Report

“…In summary, this 66-year-old female presented with a spinal schwannoma with atypical imaging. Though the radiographic appearance of spinal schwannomas, demonstrating T2 hyperintensity with avid contrast enhancement has been well-described, 5,8 this patient's tumor was T2 hypointense and had a somewhat serpiginous morphology, leading the clinical team to believe this most likely represented an intradural vascular lesion. In fact, in the cervical region, T2 hypointensity has been used to differentiate the normal ganglia of the cervical sympathetic chain from schwannomas.…”

Intraoperative Anatomical Findings in Pediatric Clear Cell Meningioma of the Lumbar Spine: Case Report and Literature Review

“…3,5,6,[10][11][12][13][14][16][17][18]25,29,30) In such cases, the tumor is often attached to the nerve root. Lee et al reported that 15 (83.3%) of 18 cases of spinal meningiomas did not have a dural attachment, 34) and lack of dural attachment is characteristic of this disease. A case of deep sylvian meningioma without dural attachment is also reported recently.…”

“…15,22,37) It also demonstrates a high absorption zone on CT. 23) Dural tail sign is not seen, in contrast to other meningiomas. 34,38) When a spinal cord tumor with these meningioma features is found, especially in young patients, the possibility of CCM should be kept in mind. 6,15) CCMs have greater recurrences compared with other meningiomas and is a WHO classification Grade II.…”

“…10,22) In general, meningiomas are tumors that arise from arachnoid superficial cells and are most commonly at the intracranial and spinal level, with those occurring in the cauda equina being rare. 3) Meningiomas generally adhere to the dura mater, 33,34) but cases of CCM not attached to the dura have been reported. 3,5,6,[10][11][12][13][14][16][17][18]25,29,30) In such cases, the tumor is often attached to the nerve root.…”

“…3 , 4) Spinal cord CCMs in children are very rare, and to the best of our knowledge, there have been 41 cases of pediatric spinal CCM cases reported. 3 , 5 – 32) Meningiomas, as a rule, adhere to the dura mater, 33 , 34) but one of the characteristics of CCMs is that 15 cases have been reported at the moment in which there was no dural attachment. 3 , 5 , 6 , 10 – 14 , 16 – 18 , 25 , 29 , 30) There is therefore currently no settled opinion on the origin of these tumors, 13 , 33 , 35) and no report has ever reviewed the intraoperative findings in detail.…”