Primary Intraosseous Meningioma of the Vertebra: Illustrative Case

Overview

Journal J Neurosurg Case Lessons

Specialty Neurology

Date 2022 Jul 20

PMID 35855279

Authors

Ue-Cheung Ho

Koping Chang

Yen-Heng Lin

Yu-Cheng Huang

Fon-Yih Tsuang

Affiliations

Soon will be listed here.

Abstract

Background: Primary 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.

Observations: A 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.

Lessons: The 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.

Citing Articles

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PMID: 37287574 PMC: 10243846. DOI: 10.1093/noajnl/vdad013.

References

Omofoye O, Huynh T, Jhun R, Ashfaque H, Cronk K . Primary intraosseous meningioma of the calvarium: A systematic review. Clin Neurol Neurosurg. 2020; 199:106283. DOI: 10.1016/j.clineuro.2020.106283. View

Lang F, Macdonald O, Fuller G, Demonte F . Primary extradural meningiomas: a report on nine cases and review of the literature from the era of computerized tomography scanning. J Neurosurg. 2000; 93(6):940-50. DOI: 10.3171/jns.2000.93.6.0940. View

Kwon S, Ko Y, Bang S . Primary intraosseous osteolytic meningioma: a case report and review of the literature. BMC Neurol. 2019; 19(1):176. PMC: 6647308. DOI: 10.1186/s12883-019-1392-5. View

Arana E, Diaz C, Latorre F, Menor F, Revert A, Beltran A . Primary intraosseous meningiomas. Acta Radiol. 1996; 37(6):937-42. DOI: 10.1177/02841851960373P299. View

Boriani S . resection in the spine: a procedure of surgical oncology. J Spine Surg. 2018; 4(3):668-676. PMC: 6261759. DOI: 10.21037/jss.2018.09.02. View

Huang Y, Tsuang F, Lee C, Wu C, Lin Y . Assessing Vascularity of Osseous Spinal Metastases with Dual-Energy CT-DSA: A Pilot Study Compared with Catheter Angiography. AJNR Am J Neuroradiol. 2019; 40(5):920-925. PMC: 7053889. DOI: 10.3174/ajnr.A6023. View

Mukherjee D, Hu J, Chu R . Isolated Extracranial Intraosseous Metastasis of an Intracranial Meningioma following Bevacizumab Therapy: Case Report and Review of the Literature. Asian J Neurosurg. 2018; 13(1):98-101. PMC: 5820909. DOI: 10.4103/1793-5482.185057. View

Butscheidt S, Ernst M, Rolvien T, Hubert J, Zustin J, Amling M . Primary intraosseous meningioma: clinical, histological, and differential diagnostic aspects. J Neurosurg. 2019; 133(2):281-290. DOI: 10.3171/2019.3.JNS182968. View

Caruso R, Fini G, Pesce A, Wierzbicki V, Marrocco L, Piccione E . A primary intraosseous cystic meningioma: Case report. Int J Surg Case Rep. 2017; 37:189-192. PMC: 5508490. DOI: 10.1016/j.ijscr.2017.06.049. View

10.

Ward A, Risman A, Segar S, Sharma S, Vender J . Atypical Intracranial Meningioma with Metastasis to C7 Vertebral Body: A Case Report. World Neurosurg. 2018; 122:593-598. DOI: 10.1016/j.wneu.2018.11.067. View

11.

Chen T . Primary Intraosseous Meningioma. Neurosurg Clin N Am. 2016; 27(2):189-93. DOI: 10.1016/j.nec.2015.11.011. View

12.

Kim H, Jung T, Kim I, Lee J . Two cases of primary osteolytic intraosseous meningioma of the skull metastasizing to whole skull and the spine. J Korean Neurosurg Soc. 2012; 51(3):151-4. PMC: 3358602. DOI: 10.3340/jkns.2012.51.3.151. View

13.

Buerki R, Horbinski C, Kruser T, Horowitz P, James C, Lukas R . An overview of meningiomas. Future Oncol. 2018; 14(21):2161-2177. PMC: 6123887. DOI: 10.2217/fon-2018-0006. View

14.

Rushing E, Bouffard J, McCall S, Olsen C, Mena H, Sandberg G . Primary extracranial meningiomas: an analysis of 146 cases. Head Neck Pathol. 2009; 3(2):116-30. PMC: 2715454. DOI: 10.1007/s12105-009-0118-1. View

15.

Choi K, Chung K, Kim Y . Primary intraosseous meningioma. Arch Plast Surg. 2015; 42(3):378-80. PMC: 4439606. DOI: 10.5999/aps.2015.42.3.378. View

16.

Tamura H, Otani Y, Iwazawa T, Kashii M, Ando H, Doi R . Extracranial meningiomas concurrently found in the lung and vertebral bone: a case report. J Med Case Rep. 2018; 12(1):279. PMC: 6161374. DOI: 10.1186/s13256-018-1826-5. View

17.

Vlychou M, Inagaki Y, Stacey R, Athanasou N . Primary intraosseous meningioma: an osteosclerotic bone tumour mimicking malignancy. Clin Sarcoma Res. 2016; 6:14. PMC: 4983411. DOI: 10.1186/s13569-016-0054-2. View

18.

Elder J, Atkinson R, Zee C, Chen T . Primary intraosseous meningioma. Neurosurg Focus. 2007; 23(4):E13. DOI: 10.3171/FOC-07/10/E13. View

19.

Harary M, Tung J, Sood S, Corrales C, Smith T, Iorgulescu J . Benign purely intraosseous meningioma of the skull: Diagnosis and surgical outcomes. J Clin Neurosci. 2020; 82(Pt A):36-42. PMC: 7738764. DOI: 10.1016/j.jocn.2020.10.040. View