Abstract

IntroductionThoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure. Presentation of caseA 42-year-old female complaining of back pain for one year and progressive weakness and numbness of both lower limbs with urinary incontinence and constipation for two months. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. The patient underwent laminectomy at D3-D5 level, revealing dural bulge. A midline durotomy performed. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Simpson grade 3 resection was performed. Pedicle screw and rod was placed for posterior stabilization. Histopathological examination demonstrated a psammomatous spinal meningioma. Despite the pain and the sensory sensation was improved, the motoric and autonomic function still showed no significant improvement in the early postoperative period. DiscussionThe preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. Meanwhile, the prognosis for recovery depends mainly on two factors: the severity of the neurological deficit and the duration of the deficit before decompression. ConclusionSurgical resection of the tumor may relieve the spinal cord compression in a neglected case. Even though the neurologic function after surgery rarely returns to the functional stage due to chronic neural tissue damage.

Highlights

  • Thoracic spinal psammomatous meningioma is a rare subtype of meningioma

  • We report a rare case of intramedullary psammomatous meningioma of the thoracic spine in a 42-year-old female

  • The Magnetic Resonance Imaging (MRI) of the dorsal spine revealed an intramedullary spinal lesion extending from midbody of D3 to midbody of D4 vertebra, which was hypointense on T3 and T4 (Fig. 1)

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Summary

INTRODUCTION

Thoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Histopathological examination demonstrated a psammomatous spinal meningioma. DISCUSSION: The preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. CONCLUSION: Surgical resection of the tumor may relieve the spinal cord compression in a neglected case. Even though the neurologic function after surgery rarely returns to the functional stage due to chronic neural tissue damage

Introduction
Presentation of case
Discussion
Conclusion
Findings
Ethical approval
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