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Abstract
Objectives
The aim of this study was to report 2 cases of calcified spinal meningioma that displayed differences in appearance during resection, and to review the current literature on calcified and ossified spinal meningiomas.
Summary of Literature Review
Calcified and ossified spinal meningiomas are rare, and tumor calcification is a risk factor for poor neurological outcomes resulting from the additional manipulations required to dissect the tumor.
Materials and Methods
We describe the clinical course and intraoperative findings of 2 female patients who presented with symptoms of myelopathy. Magnetic resonance imaging showed calcified spinal meningiomas of the thoracic spine. The type of tumor resection performed was dependent on the solidity and texture of the individual tumors.
Results
Pathologic evaluation revealed psammoma bodies, which suggested calcified meningioma. The patients’ neurologic symptoms resolved with no neurologic sequelae.
Conclusions
Although there are a few pathologic differences regarding the main type and pathogenesis of ossified and calcified meningioma, both are thought to have a poor prognosis. For these tumors, adequately accounting for the expected poor prognosis and performing a wide laminectomy in order to ensure an adequate surgical margin are important factors for achieving a favorable outcome.
REFERENCES
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Fig. 1.
A sagittal plane T2-weighted magnetic resonance imaging scan exhibited a very low signal (white arrow) in an intradural ex-tramedullary tumor occupying the spinal canal at T4 (A). Computed tomography without enhancement depicted a completely calcified intradural mass (black arrow) occupying the entire spinal canal at the T4 level. The axial view is shown in (B).
Fig. 2.
Intraoperative image showing a tumor (white arrow) at the T4 level. The tumor had a friable solidity and was dissected in a piecemeal manner.
Fig. 3.
Postoperative T2-weighted magnetic resonance imaging scan revealing decompression of the flattened cord and recovery of the cord diameter in the thoracic spine. The sagittal view is shown in (A), and the axial view in (B).
Fig. 4.
Microscopy of the specimen demonstrating a psammomatous subtype that was composed of numerous calcified psammoma bodies, suggestive of a calcified meningioma (hematoxylin and eosin staining, ×200 magnification).
Fig. 5.
T2-weighted magnetic resonance imaging scan showing an oval-shaped mass (white arrow) clearly demarcated by a hypodense signal. The sagittal view shown in (A). Computed tomography image showing a calcified mass (black arrow) occupying the spinal canal at the level of the T9 vertebra. The axial view is shown in (B).
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