Multiple spinal and cranial meningiomas: A case report and review of literature

Abstract

Though meningiomas are common neoplasms of the nervous system, the occurrence of multiple meningiomas in different neuraxial compartments is rather rare. We report a case of a 62-year-old female who presented with spastic paraparesis in both lower limbs, and was found to have multiple homogenously enhancing tumors of dorsolumbar spine. Cranial magnetic resonance imaging (MRI) revealed multiple bilateral supratentorial meningiomas. She underwent multiple level laminectomy and total removal of spinal tumors after which power improved in both lower limbs. Histopathology revealed psammomatous meningiomas. Only around 19 cases of multiple cranial and spinal meningiomas have been reported, of which, only five cases have more than one spinal meningioma. The implication of the incidence of such multiple meningiomas in the same patient with relevance to investigations and decision making are discussed along with a brief review of literature of cases with multiple spinal and cranial meningiomas.

Multiple Spinal Canal Meningiomas

“…4 Spinal meningiomas account for 25 percent of all spinal cord tumours and usually they are solitary. 1,4 Multiple spinal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas. 2,3,4 Multiple meningiomas defined as simultaneous or sequential appearance of 2 or more independently situated meningiomas of any histopathological type.…”

“…DOI: 10.18410/jebmh/2016/1000 BACKGROUND Spinal canal meningiomas account for 25 percent of all spinal cord tumors. 1 and usually they are solitary. Multiple spinal meningiomas are rare in compare to solitary lesions and account for 2 to 3.5% of all spinal meningiomas.…”

“…4 Most of the reported cases of multiple spinal meningiomas are both intra cranial and spinal. 1 Exclusive involvement of the spinal canal by multiple meningiomas are very rare. 1,5 To the best of our knowledge we could find only sixteen case series were reported in the literature.…”

“…1 Exclusive involvement of the spinal canal by multiple meningiomas are very rare. 1,5 To the best of our knowledge we could find only sixteen case series were reported in the literature. 2,3,[6][7][8][9][10][11][12][13][14][15][16][17][18][19] Exclusive multiple spinal canal meningiomas occurring in the first two decades of life are seldom reported in the literature.…”

Multiple Meningiomas in Different Neuraxial Compartments with Klippel-Feil Malformation: A Case Report

“…Multiple spinal meningiomas are rarer than multiple cranial meningiomas. Multiple meningiomas occurring in different neuraxial compartments are rarer, with only six cases having multiple spinal and multiple cranial meningiomas (6) . The pathogenesis of multiple meningiomas can be explained in two ways, either these tumors arise independently as evidenced by the histological and cytogenetic differences between multiple tumors from the same patient, or a single transforming event occurs and the original clone of cells spreads throughout the meninges in the formation of multiple, clonally related tumors (1) .…”