Malignant intracranial meningioma with spinal metastasis--case report

Neurol Med Chir (Tokyo). 2009 Jun;49(6):258-61. doi: 10.2176/nmc.49.258.

Abstract

A 48-year-old woman presented with a left cerebellopontine angle mass. Over a 93-month period, the patient underwent seven surgeries, two radiosurgeries, and one external beam radiotherapy. The tumor was histologically benign at the first operation, but exhibited unusually aggressive behavior after failed radiosurgery and demonstrated clinical characteristics of malignancy such as spinal metastasis. The patient underwent gamma knife radiosurgery (GKR) for recurrence after the first operation, despite the tumor being located in a resectable region. The tumor did not respond. Six months after the sixth surgery, the patient presented with progressive lower extremity paraparesis and sensory disturbance below the T11 dermatome. Magnetic resonance imaging revealed multiple intradural mass lesions located at the T2, T11-T12, and L2 levels. She died 4 months after the diagnosis of spinal metastases. Retrospectively, we speculate that if a tumor is located in a resectable region and Simpson grade I or II tumor resection is possible, direct surgery may be a safer option than GKR.

Publication types

  • Case Reports

MeSH terms

  • Cell Transformation, Neoplastic / radiation effects*
  • Cerebellopontine Angle / pathology
  • Cerebellopontine Angle / surgery
  • Fatal Outcome
  • Female
  • Humans
  • Iatrogenic Disease / prevention & control
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms / pathology*
  • Meningeal Neoplasms / surgery
  • Meningioma / secondary*
  • Meningioma / surgery
  • Middle Aged
  • Neoplasm Metastasis / pathology
  • Neoplasm Metastasis / physiopathology*
  • Neoplasm Metastasis / prevention & control
  • Neurosurgical Procedures / methods
  • Neurosurgical Procedures / standards
  • Paraparesis / etiology
  • Paraparesis / pathology
  • Paraparesis / physiopathology
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Radiosurgery / adverse effects*
  • Radiosurgery / standards
  • Reoperation
  • Retrospective Studies
  • Spinal Cord / pathology
  • Spinal Cord / physiopathology
  • Spinal Cord Neoplasms / secondary*
  • Subarachnoid Space / pathology
  • Subarachnoid Space / physiopathology
  • Thoracic Vertebrae