The application of surgical cordectomy in the management of an intramedullary-extramedullary atypical meningioma: case report and literature review.

Abstract

BACKGROUND:

The English literature describes only four cases of intraspinal tumors requiring surgical intervention in the form of cordectomy; none of these cases was for meningiomas. Intraspinal meningiomas, typically extramedullary-intradural, require treatment in the form of resection with dural margin excision. The presentation of an intramedullary atypical World Health Organization grade II meningioma is rare. The authors report a case of a transformed intramedullary-extramedullary atypical meningioma treated with cordectomy.

METHODS:

The patient was a 65-year-old woman who presented with a recurrent thoracic meningioma status post three attempted resections, radiation therapy, and a trial of hydroxyurea chemotherapy. The patient presented paraplegic with reports of burning paresthesias bilaterally in her upper extremities 12 months after her third resection attempt.

RESULTS:

Magnetic resonance imaging on this current presentation revealed a heterogeneously enhancing hypointense mass extending from T2 to T6. Extension of abnormal T2 signal within the cord superiorly to C7 was noted with a 1-cm enhancing extra-axial lesion at T10 and an extradural mass posteriorly T12 also noted. The patient underwent a T2-T7 laminectomy with a T2-T8 cordectomy. Two months postoperatively, the patient was doing well with no further deterioration in neurologic function.

CONCLUSIONS:

This case highlights the viability of surgical cordectomy in the treatment of varying intramedullary processes under appropriate indications.

• Authors: Shaan M Raza, William S Anderson, Charles G Eberhart, Jean-Paul Wolinsky, Ziya L Gokaslan
• Journal: Journal of spinal disorders & techniques (J Spinal Disord Tech) Vol. 18 Issue 5 Pg. 449-54 (Oct 2005) ISSN: 1536-0652 [Print] United States
• PMID: 16189459 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Aged
• Female
• Humans
• Meningeal Neoplasms (pathology, surgery)
• Meningioma (pathology, surgery)
• Neoplasm Recurrence, Local (pathology, surgery)
• Spinal Cord (surgery)
• Thoracic Vertebrae