Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2012 Jun;19(2):72-76. Korean.
    Published online Jun 30, 2012.
    https://doi.org/10.4184/jkss.2012.19.2.72
    © Copyright 2012 Korean Society of Spine Surgery
    Case Report

    Ossified Meningioma - A Case Report -

    Dong Ki Ahn, M.D., Sang Ho Moon, M.D., Song Lee, M.D., Tae Woo Kim, M.D., Jeehyoung Kim, M.D., Seong Won Hong, M.D. and Dae Geun Kim, M.D.
      • Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Seoul, Korea.
    • Corresponding author: Sang Ho Moon, M.D. Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, 40-12, Chungryangri-dong, Dongdaemoon-gu, Seoul, 130-011, Korea. TEL: 82-2-968-2394, FAX: 82-2-966-1616, Email: msh124@paran.com
    Received August 23, 2011; Revised February 20, 2012; Accepted March 05, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Abstract

    Study Design

    A case report

    Objectives

    To report an extremely rare case of the spinal meningioma containing bone.

    Summary of Literature Review

    Spinal meningiomas represent 16.6-46.7% of the primary spinal tumors and 1 to 5% of them are calcified. Ossification is an extremely uncommon event that complicates the resection surgery.

    Materials and Methods

    We experienced a 59-year-old patient who complained of weakness in the lower limbs and gait disturbance. Spinal cord compressing mass was discovered on a MRI at T6 and there was a vertical plate at the posterior side of the mass. Surgical finding showed complete ossification in the dural attachment site of the mass. Though the tumor mass could be excised with the inner layer of the dura mater en masse, more forceful retraction of the spinal cord was unavoidable than the other soft mass resection.

    Results

    The preoperative neurological impairment improved after the surgery and she was able to walk well.

    Conclusions

    Ossification makes a resection difficult and vulnerable to develop neurological deterioration. But if we could suspect such an ossification through an image test, it would be helpful to make a surgical plan to avert a neurologic complication.

    Keywords
    Meningioma; Ossification; Spinal tumor

    Figures

    Fig. 1
    Preoperative MRI revealed solid intradural, extramedullary tumor measuring 1cm in diameter located at the level of T6 spinal canal. Ovoid mass was compressing the spinal cord. The lesion showed mixed intensity on the T1-weighted image and hypointensity on the T2-weighted image. On the distal posterior aspect of tumor, there was a plate-shaped lesion like a tail on T1 and T2-weighted images(arrow). The gadolinium-enhanced image showed homogeneous enhancement. (A) T1-weighted sagittal (B) T2-weighted sagittal (C) Enhanced sagittal (D) T2-weighted axial.

    Fig. 2
    Intraoperative photography showed well marginated 1.0×0.8×0.7cm-sized yellowish - red soft tissue mass containing plate-shaped mature woven bone(arrow).

    Fig. 3
    Histologic finding showed mixed pattern or intermediate features of meningothelial and fibrous meningiomas. In the lower part of this histologic feature, mature lamellar bone formation was shown(H&E, ×40).

    Fig. 4
    Photomicrograph showing characteristic concentric meningeal whorls(H&E, ×100).

    References

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    MeSH Terms
    Dura Mater
    Gait
    Humans
    Lower Extremity
    Meningioma
    Middle Aged
    Spinal Cord
    Metrics
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