Article Access Statistics | | Viewed | 4350 | | Printed | 185 | | Emailed | 1 | | PDF Downloaded | 48 | | Comments | [Add] | | Cited by others | 5 | |
|

 Click on image for details.
|
|
|
LETTER TO EDITOR |
|
|
|
Year : 2011 | Volume
: 59
| Issue : 1 | Page : 132-134 |
Cervical en-plaque epidural meningioma
Weiying Zhong, Haifeng Chen, Siqing Huang, Chao You
Department of Neurosurgery, West China Hospital, Sichuan University, NO 37, GuoXue Xiang, Chengdou, Sichuan Province, China
Date of Submission | 10-Jul-2010 |
Date of Decision | 11-Jul-2010 |
Date of Acceptance | 07-Aug-2010 |
Date of Web Publication | 18-Feb-2011 |
Correspondence Address: Siqing Huang Department of Neurosurgery, West China Hospital, Sichuan University, NO 37, GuoXue Xiang, Chengdou, Sichuan Province China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.76873
How to cite this article: Zhong W, Chen H, Huang S, You C. Cervical en-plaque epidural meningioma. Neurol India 2011;59:132-4 |
Sir,
A 35-year-old woman was admitted for neck pain of 2 years' duration. Neurological examination revealed motor weakness of 3/5 on the right side and 4/5 on the left side and sensory loss below C7 segment. Bilateral Hoffmann and Babinski signs were positive. Cervical magnetic resonance imaging (MRI) revealed an epidural mass on the right side with ventral and dorsal extension from C2 to C6. The lesion was isointense on T1-weighted and slightly hyperintense on T2- weighted images with homogeneous enhancement [Figure 1],[Figure 2],[Figure 3],[Figure 4]. Spinal angiography revealed no abnormality of cervical spinal vessels. Subtotal resection was performed. At operation, the lesion was located in the epidural space adherent firmly to the dura mater with intervertebral foramen extension. Histology confirmed the diagnosis of epidural meningioma. | Figure 1: The lesion was located in the epidural space from C2 to C6 with ventral and dorsal extension and was isointense to the spinal cord on T1- weighed images
Click here to view |
 | Figure 3: The lesion was mainly located in the right lateral, ventral and dorsal side of epidural space from C2 to C6. It was seen as a homogeneous enhancement immediately after administration of gadolinium
Click here to view |
 | Figure 4: The lesion encircled the dura mater with intervertebral foramen extension. It was seen as a homogeneous enhancement immediately after administration of gadolinium
Click here to view |
Meningiomas are the second most common intraspinal tumors and usually arise from the intradural-extramedullary space and are located in the thoracic region of the spine. Solitary epidural spinal meningiomas account for 2.7% to 10% of all spinal meningiomas, [1],[2] more common in children and men and more aggressive than intradural meningiomas. [3] En-plaque epidural meningiomas are sheet-like or collar-like meningiomas encircling and infiltrating the dura mater, and only a few cases have been reported. [2],[3],[4]
Epidural spinal meningiomas are usually isointense to the spinal cord on T1-weighted and isointense or slightly hyperintense on T2-weighted images with homogeneous enhancement. [1],[4] They can arise in any part of the dural sac with dura mater encirclement and several vertebral levels extension, especially en-plaque ones. The lesions can erode vertebra with intervertebral foramen widening and vertebral body arc changes but rarely with vertebra destruction. The dural attachment stalk is an essential component for the diagnosis. [2],[3],[4] Other epidural lesions should be excluded.
Surgical resection is the main treatment for spinal meningioma. The recurrence rate mainly depends on the degree of resection, but complete resection is more difficult to achieve in epidural en-plaque meningiomas because of the location and extent of the lesion, and the attachment to dura mater. Recurrence rates are high, and the prognosis of en-plaque spinal meningiomas remains poor. [2],[3],[4]
» References | |  |
1. | EI Khamary SM, Alorainy IA. Case 100: Spinal epidural meningioma. Radiology 2006;241:614-7.  |
2. | Yamada S, Kawai S, Yonezawa T, Masui K, Nishi N, Fujiwara K. Cervical extradural en-plaque meningioma: Case report. Neurol Med Chir(Tokyo) 2007;47:36-9.  [PUBMED] [FULLTEXT] |
3. | Messori A, Rychlicki F, Salvolini U. Spinal epidural en-plaque meningioma with an unusual pattern of calcification in a 14-year-old girl: Case report and review of the literature. Neuroradiology 2002;44:256-60.  [PUBMED] |
4. | Caroli E, Acqui M, Roperto R, Ferrante L, D'Andrea G. Spinal en plaque meningiomas: A contemporary experience. Neurosurgery 2004;55:1275-9.  [PUBMED] [FULLTEXT] |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
This article has been cited by | 1 |
Imaging Appearances and Pathologic Characteristics of Spinal Epidural Meningioma |
|
| L.H. Zhang,H.S. Yuan | | American Journal of Neuroradiology. 2018; 39(1): 199 | | [Pubmed] | [DOI] | | 2 |
Cervical En-Plaque Extradural Meningioma Involving Brachial Plexus |
|
| Laxminadh Sivaraju,Sumit Thakar,Nandita Ghosal,Alangar S. Hegde | | World Neurosurgery. 2017; 108: 994.e7 | | [Pubmed] | [DOI] | | 3 |
Extensive calcification of the ligamentum flavum causing cervical myelopathy in a Caucasian woman |
|
| Milaine Roet,Jochem K. H. Spoor,M. de Waal,Max J. Kros,Sanjay B. Harhangi,Ruben Dammers | | SpringerPlus. 2016; 5(1) | | [Pubmed] | [DOI] | | 4 |
Pure spinal epidural cavernous hemangioma |
|
| Zhong, W. and Huang, S. and Chen, H. and Sun, H. and Cai, B. and Liu, Y. and You, C. | | Acta Neurochirurgica. 2012; 154(4): 739-745 | | [Pubmed] | | 5 |
Pure spinal epidural cavernous hemangioma |
|
| Weiying Zhong,Siqing Huang,Haifeng Chen,Hong Sun,Bowen Cai,Yi Liu,Chao You | | Acta Neurochirurgica. 2012; 154(4): 739 | | [Pubmed] | [DOI] | |
|
 |
|