Malignant Intracranial Meningioma With Spinal Metastasis

Hiroki KURODA, Hiroshi KASHIMURA, Kuniaki OGASAWARA, Atsushi SUGAWARA, Masayuki SASOH, Hiroshi ARAI, Akira OGAWA
2009 Neurologia medico-chirurgica  
Fig. 1 Axial T 1 -weighted with contrast medium (A) and T 2 -weighted (B) magnetic resonance images showing a tumor located in the left cerebellopontine angle, with lobulated margins (A) and perifocal edema (B). 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
more » ... ited 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.
doi:10.2176/nmc.49.258 pmid:19556736 fatcat:zsed7i6xzzb5bgprxvt6vxqv7i