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Ossification in an extra-intradural spinal meningioma-pathologic and surgical vistas.
Spine J. 2013 Dec; 13(12):e21-6.SJ

Abstract

BACKGROUND CONTEXT

Intradural and intratumorous ossification in spinal meningiomas are rare compared to their cranial counterparts. Extradural extension of the spinal meningioma is not uncommon. To the best of our knowledge, the ossification in an extra-intradural spinal meningioma is not yet reported in the literature.

PURPOSE

The authors report a rare case of an extra-intradural spinal meningioma with ossification and calcification. The review of literature including the surgical challenges and the histologic variations as well as histogenesis of the ossified spinal meningioma is discussed.

STUDY DESIGN

Case report and review of the literature.

METHODS

A 61-year-old woman presented with complaints of numbness and weakness for 3 years, and gait disturbances for 6 months. Magnetic resonance imaging revealed a mass compressing the spinal cord at the T4 level.

RESULTS

Complete resection of the tumor was achieved with coagulation and partial resection of the dura. Histopathological examination demonstrated a psammomatous spinal meningioma with intratumorous and intradural mature lamellar bone formation, complete with marrow and hematopoietic cells. The patient is asymptomatic at 3-year postoperative follow-up.

CONCLUSIONS

Despite adherence of the ossified mass to the dura, arachnoid, and spinal cord, complete atraumatic resection of the mass was possible with favorable surgical outcome. In addition to calcification as a likely forerunner of ossification in the psammomatous subtype of meningioma, metaplastic differentiation of neoplastic cells to osseous and hematopoietic component might play a crucial role.

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Authors+Show Affiliations

Chotai SP
Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, 3000 Arlington Ave, OH 43614, USA.
Mrak RE
No affiliation info available
Mutgi SA
No affiliation info available
Medhkour A
No affiliation info available

MeSH

Decompression, SurgicalFemaleHumansMeningeal NeoplasmsMeningiomaMiddle AgedOssification, HeterotopicSpinal Cord CompressionSpinal Cord Neoplasms

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24045159

Citation

Chotai, Silky P., et al. "Ossification in an Extra-intradural Spinal Meningioma-pathologic and Surgical Vistas." The Spine Journal : Official Journal of the North American Spine Society, vol. 13, no. 12, 2013, pp. e21-6.
Chotai SP, Mrak RE, Mutgi SA, et al. Ossification in an extra-intradural spinal meningioma-pathologic and surgical vistas. Spine J. 2013;13(12):e21-6.
Chotai, S. P., Mrak, R. E., Mutgi, S. A., & Medhkour, A. (2013). Ossification in an extra-intradural spinal meningioma-pathologic and surgical vistas. The Spine Journal : Official Journal of the North American Spine Society, 13(12), e21-6. https://doi.org/10.1016/j.spinee.2013.06.102
Chotai SP, et al. Ossification in an Extra-intradural Spinal Meningioma-pathologic and Surgical Vistas. Spine J. 2013;13(12):e21-6. PubMed PMID: 24045159.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ossification in an extra-intradural spinal meningioma-pathologic and surgical vistas. AU - Chotai,Silky P, AU - Mrak,Robert E, AU - Mutgi,Sunil A, AU - Medhkour,Azedine, Y1 - 2013/09/14/ PY - 2012/09/17/received PY - 2013/03/28/revised PY - 2013/06/29/accepted PY - 2013/9/19/entrez PY - 2013/9/21/pubmed PY - 2014/8/19/medline KW - Extra-intradural KW - Intradural KW - Ossification KW - Psammomatous KW - Spinal meningioma SP - e21 EP - 6 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 13 IS - 12 N2 - BACKGROUND CONTEXT: Intradural and intratumorous ossification in spinal meningiomas are rare compared to their cranial counterparts. Extradural extension of the spinal meningioma is not uncommon. To the best of our knowledge, the ossification in an extra-intradural spinal meningioma is not yet reported in the literature. PURPOSE: The authors report a rare case of an extra-intradural spinal meningioma with ossification and calcification. The review of literature including the surgical challenges and the histologic variations as well as histogenesis of the ossified spinal meningioma is discussed. STUDY DESIGN: Case report and review of the literature. METHODS: A 61-year-old woman presented with complaints of numbness and weakness for 3 years, and gait disturbances for 6 months. Magnetic resonance imaging revealed a mass compressing the spinal cord at the T4 level. RESULTS: Complete resection of the tumor was achieved with coagulation and partial resection of the dura. Histopathological examination demonstrated a psammomatous spinal meningioma with intratumorous and intradural mature lamellar bone formation, complete with marrow and hematopoietic cells. The patient is asymptomatic at 3-year postoperative follow-up. CONCLUSIONS: Despite adherence of the ossified mass to the dura, arachnoid, and spinal cord, complete atraumatic resection of the mass was possible with favorable surgical outcome. In addition to calcification as a likely forerunner of ossification in the psammomatous subtype of meningioma, metaplastic differentiation of neoplastic cells to osseous and hematopoietic component might play a crucial role. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/24045159/Ossification_in_an_extra_intradural_spinal_meningioma_pathologic_and_surgical_vistas_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(13)01257-6 DB - PRIME DP - Unbound Medicine ER -