Thoracal meningioma and neurological status recovery 6 months postoperative: A case report

Abstract

Introduction: Meningioma is the most common intradural tumor of the spinal cord in adults. Spinal meningioma arises from slow-growing arachnoid cap cells, which are generally located intradural extramedullary and grow laterally into the subarachnoid space to stretch the surrounding arachnoid. Local pain is usually the first major symptom. However, the majority of cases are diagnosed after the onset of neurological deficits or impaired walking. Case Presentation: Woman, 46 years old, with back pain radiating to both legs in the last 2 years before surgery. At 16 months before surgery, she had paralysis of both legs with bowel and bladder incontinence. Preoperative physical examination shows no muscle contraction on both lower extremities, with hypoesthesia in the Thoracal 2 dermatome. MRI examination shows intradural extramedullary mass at the level of the 2nd thoracal that compresses the entire spinal canal. Laminectomy surgery on thoracal 2 and tumor resection in toto were performed. Surgical resection showed a tumor mass of 2x1,2x1cm with a thick, spongy, brownish-yellow consistency. Histopathological examination shows psammomatous type meningioma, WHO Grade 1. The patient was discharged postoperatively with palpable muscle contractions on both legs, accompanied by no sensory abnormalities. Evaluation 1 month postoperatively, the patient was able to voluntarily move the lower extremities accompanied by the return of ability to micturate and defecate. Examination at 6 months postoperatively, the patient was able to walk without assistance and no other neurological deficit was found. Conclusion: Tumor resection remains as treatment of choice for spinal meningioma regardless of neurological deficit onset and histological type of tumor.