Delayed Manifestation of Sacral Clear Cell Meningioma Distent Metastasis or Multifocal Disease?

Habib Nouri, Leila Abid, Moez Ouertatani, Dalenda Hentati, Mondher Mestiri, Habib Jaafoura
2011 Surgical Science  
Study Design: the authors report on a clear cell meningioma (CCM) of the sacrum revealed 17 years after a removal of a spinal lesion. A review of 29 spinal CCM previously reported was done. Objective: To focus on clinical and biological behaviour of CCM. Summary of Background Data: CCM is a rare subtype characterrized by its inordinately aggressive clinical course despite its benign appearance. The tumour shows proclivity for the cerebellopontine angle and cauda equine region. Recurrence and
more » ... . Recurrence and metastasis have been commonly reported. Method: a 26 year-old man presented with low back pain related to a lytic lesion of the sacrum. He had a history of an intradural extramedullary meningioma of the cervical spine removed when he was 9 year-old. CT scan revealed a sacral osteolytic lesion with anterior and lateral extension. Open biopsy revealed a clear cell meningioma. That was the same pattern of the tumour removed 17 years before. Results: Our patient was managed conservatively by palliative radiation therapy. At 2 years follow-up, he experienced improvement of pain and walking. Conclusion: CCM is an aggressive tumour with a high risk of metastases through cerebrospinal fluid. A follow up with spinal MRI should be performed.
doi:10.4236/ss.2011.26064 fatcat:je5ceae3bfbhhavtsamvdimlee