Abstract
BACKGROUNDPrimary intraosseous meningiomas (PIMs) are rare, and PIMs of the vertebrae have not yet been reported. The authors report a case of primary meningioma arising from the vertebrae.OBSERVATIONSA 49-year-old man presented with lower back pain and numbness in both lower extremities. Lumbar spine magnetic resonance imaging revealed an L2 pathological fracture with epidural and paraspinal invasion. The patient had undergone a first palliative decompression and fixation surgery, and the diagnosis turned out to be a World Health Organization grade III anaplastic meningioma based on histopathology. The tumor had progressed after first operation and radiation therapy, and the patient was referred to the authors’ institute for excision. The patient had an uneventful postoperative course after a revisional total en bloc spondylectomy of L2.LESSONSThe authors present a rare case of PIM of the vertebrae with epidural and paraspinal invasion. Careful preoperative assessment and surgical planning is crucial for successful patient management.
Highlights
Primary intraosseous meningiomas (PIMs) are rare, and primary intraosseous meningioma (PIM) of the vertebrae have not yet been reported
Meningiomas can metastasize to skull, bone, or spine from a primary intracranial origin,[2,3,8,9] or they can develop as a primary intraosseous meningioma (PIM) in bone
Observations In the past, the nomenclature for meningioma arising outside of the intracranial compartment varied across studies
Summary
Primary intraosseous meningiomas (PIMs) are rare, and PIMs of the vertebrae have not yet been reported. Meningiomas are the most common primary intracranial tumors and comprise approximately 35% of all primary central nervous system tumors.[1,2] Most meningiomas develop intracranially In rare cases, they can develop extracranially; such cases account for less than 2% of all meningiomas.[3,4,5] This type of meningioma is called primary extradural meningioma (PEM), and it can occur in several locations, such as the skull, skin, paranasal sinuses, orbit, temporal fossa, and oral cavity.[3,4,6,7] Meningiomas can metastasize to skull, bone, or spine from a primary intracranial origin,[2,3,8,9] or they can develop as a primary intraosseous meningioma (PIM) in bone. World Health Organization (WHO) grade III anaplastic meningioma based on the histopathology results
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