Spinal angiomatous meningioma in the thoracic region: a case report

Abstract

Abstract. Meningiomas are divided into three subtypes according to the World Health Organization (WHO), which give rise to about 15 histological variants with varying degrees of malignancy. WHO grade I tumors are the most common, which are predominantly benign in nature and have a good prognosis after total surgical removal. Spinal meningiomas are one of the most common intradural, extramedullary tumors, accounting for about 20% of all lesions localized on the spinal cord and its envelope. Meningiomas arise from arachnoid cells and have a very close relationship with the dural meninges. They can be located in all places where there are arachnoid cells and cause neurological symptoms. Due to their slow-growing nature, symptoms manifest within a few months. In this report, we present an unusual case of a 44-year-old woman with spinal angiomatous meningioma presenting with the clinicopathology of inferior spastic paraplegia debuting at eight months, pelvic reservoir disorders, and decreased bowel motility, resulting in neurological paresis of the latter. The patient underwent two operations for hydrocephalus with normal pressure and subsequent infection of the ventricular catheter, which required its removal in the neurosurgical department and prolonged antibiotic treatment. The woman stayed for about three months in the intensive care unit with the clinical picture of meningitis and secondary superimposed pulmonary pneumonia. Magnetic resonance imaging of the thoracic region revealed a heterogeneous cystic formation over a wide area, and a tumor formation or arachnoiditis in the chronic phase was considered in the differential diagnosis. Surgical treatment with partial extirpation of the pathological formation (Simpsom grade III) was undertaken, and the histological diagnosis confirmed the presence of an angiomatous meningioma in the thoracic region.