A Rare Extradural Spinal Meningioma with Nocturnal Chest Pain - A Case Report -

Sang Bum Kim; Yougun Won; Min Gu Jang; Young Ki Min; Andreas Gutzeit; Fabio Casari; Oliver Nic Hausmann

doi:10.4184/jkss.2019.26.3.100

Journal List > J Korean Soc Spine Surg > v.26(Suppl 1) > 1135075

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Kim, Won, Jang, Min, Gutzeit, Casari, and Hausmann: A Rare Extradural Spinal Meningioma with Nocturnal Chest Pain - A Case Report -

Case Report

Journal of Korean Spine Surg 2019;26(3):100-103.

Published online: 30 September 2019

DOI: https://doi.org/10.4184/jkss.2019.26.3.100

A Rare Extradural Spinal Meningioma with Nocturnal Chest Pain - A Case Report -

Sang Bum Kim, M.D., Ph.D.^∗, Yougun Won, M.D.^†,, Min Gu Jang, M.D.^†, Young Ki Min, M.D.^†, Andreas Gutzeit, M.D.^‡, Fabio Casari, M.D.^∮, Oliver Nic Hausmann, M.D.^∥

^∗Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Korea

^†Department of Orthopedic Surgery, Konyang University College of Medicine, Korea

^‡Department of Radiology, Klinik St. Anna, Luzern, Switzerland and Department of Radiology, Salzburg University Hospital, Austria

^∮University of Salzburg, Austria

^∥Department of Neurosurgery, Klinik St. Anna, Luzern, Switzerland

Corresponding author: Yougun Won, M.D. ORCID ID: Sang Bum Kim: https://orcid.org/0000-0002-7497-9077 Yougun Won: https://orcid.org/0000-0002-0874-5248 Young Ki Min: https://orcid.org/0000-0001-8073-5434 Department of Orthopedic Surgery, College of Medicine, Konyang University 685, Gasoowon-dong, Seo-Gu, Daejeon 35365, Korea (R.O.K) TEL: +82-42-600-9862, FAX: +82-42-545-2373 E-mail: yougunwon@gmail.com, yougunwon@kyuh.ac.kr

Received 16 November 20181 February 2019 Accepted 15 July 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Case report.

Objectives

To report a rare case of a spinal extradural meningioma in a patient with longstanding nonspecific thoracic nocturnal pain

Summary of Literature Review

Meningioma is a frequent intradural extramedullary tumor that is associated with pain, sensory/motor deficits, and sphincter weakness. Spinal meningiomas most commonly occur in the thoracic spine, although they can also be found at other locations.

Materials and Methods

A 65-year-old woman first visited the cardiac and gastrointestinal departments of our institution due to chest pain 2 years previously. No explanation for the complaint could be found in the heart or other organs. On a computed tomography scan of the thorax, a spinal mass was found a few months before the diagnosis. On magnetic resonance imaging, an extramedullary and extradural mass was observed at T7/8.

Results

We performed surgery and found an extradural spinal meningioma upon the histological diagnosis. Postoperatively, the patient could adequately move both legs and feet and the nocturnal chest pain disappeared after surgery without any complications.

Conclusions

Awareness of the rarity and nonspecific symptoms of extradural spinal meningiomas will be beneficial for their accurate diagnosis and proper treatment.

Keywords: Extradural space, Thoracic pain, Iatrogenic dural injury, Spinal meningioma, Spine tumors

REFERENCES

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Fig. 1.

Sagittal T1-weighted (T1W), T2-weighted (T2W), and T1 fat-suppressed and gadolinium-containing contrast-enhanced magnetic resonance imaging scan. (A) T1W image showing an isointense extradural lesion at the T8 level. (B) T2 fat-suppressed image showing a hypointense lesion. (C) T1 gadolinium-containing contrast-enhanced image showing an extradural lesion with some heterogeneity, but mostly a hyperintense signal.

Fig. 2.

Sagittal T1-weighted image showing an isointense extradural lesion on T8, mainly on the right side. The lesion extended along the fora-men.

Fig. 3.

Axial T1-weighted fat-suppressed gadolinium-containing contrast-enhanced magnetic resonance imaging scan showing an extradural lesion with some heterogeneity, but mostly a hyperintense signal at T8. The mass on the right side was pushing the cord to the left.

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