• Investigative Magnetic Resonance Imaging
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• v.22 no.4
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• pp.260-265
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• 2018

Chordoid meningioma, an uncommon subtype of meningioma, occurs rarely in the spine. In this case report, the authors present a case of spinal chordoid meningioma in a young female patient, and include a detailed description of imaging findings and a literature review.

• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.71-74
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• 2011

A 34-year-old female patient was presented with leg and hip pain for 6 months as well as voiding difficulty for 1 year. Magnetic resonance imaging revealed a well-demarcated mass lesion at L2-3. The mass was hypo-intense on T1- and T2-weighted images with homogeneous gadolinium enhancement. Surgery was performed with the presumptive diagnosis of intradural extramedullary meningioma. Complete tumor removal was possible due to lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma, a rare and newly included World Health Organization classification of meningioma usually affecting younger patients. During postoperative 2 years, the patient has shown no evidence of recurrence. We report a rare case of cauda equina clear cell meningioma without any dural attachment.

• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.97-100
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• 2018

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.

• Journal of Korean Neurosurgical Society
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• v.38 no.1
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• pp.54-60
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• 2005

The clear cell meningioma[CCM] is a rare and recently described as a histologic variant of meningioma. It has been identified and included in new World Health Organization[WHO] classification of the Central Nervous System[CNS] tumors recently. The CCMs are histologically characterized by sheets of spindled to polygonal cells with clear cytoplasm, which is the expression of high glycogen concentration. The CCMs occur in younger patients and usually are located in the spinal canal and posterior fossa. The most interesting aspect of CCM is the high recurrence rate and aggressiveness. Poor outcome has been shown in intracranial and spinal tumor location, but the indicators that predict outcome have not been established. Until now 22 intracranial CCM cases had been reported in English literature and 3 cases in Korean. The authors report two cases of CCM located at cerebral convexity and one at cavernous sinus those were totally removed [Simpson Grade $I{\sim}II$] by subfrontal, frontal and orbitocranial approaches. The clinical, radiological, histopathological, and neurosurgical features of these cases are discussed with the relevant literatures.

• Journal of Korean Neurosurgical Society
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• v.56 no.6
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• pp.509-512
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• 2014

Primary intraosseous meningioma is a rare tumor, and atypical pathologic components both osteolytic lesion and dura and soft tissue invasion is extremely rare. A 65-year-old woman presented with a 5-month history of a soft mass on the right frontal area. MR imaging revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the right frontal bone, and CT showed a destructive skull lesion. The mass was adhered tightly to the scalp and dura mater, and it extended to some part of the outer and inner dural layers without brain invasion. The extradural mass and soft tissue mass were totally removed simultaneously and we reconstructed the calvarial defect with artificial bone material. The pathological study revealed an atypical meningioma as World Health Organization grade II. Six months after the operation, brain MR imaging showed that not found recurrence in both cranial and spinal lesion. Here, we report a case of primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.373-378
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• 2013

Objective : We present our experience of conventional posterior approach without fat lateral approach for ventral foramen magnum (FM) meningioma (FM meningioma) and tried to evaluate the approach is applicable to ventral FM meningioma. Methods : From January 1999 to March 2011, 11 patients with a ventral FM meningioma underwent a conventional posterior approach without further extension of lateral bony window. The tumor was removed through a working space between the dura and arachnoid membrane at the cervicomedullary junction with minimal retraction of medulla, spinal cord or cerebellum. Care should be taken not to violate arachnoid membrane. Results : Preoperatively, six patients were of Nurick grade 1, three were of grade 2, and two were of grade 3. Median follow-up period was 55 months (range, 20-163 months). The extent of resection was Simpson grade I in one case and Simpson grade II in remaining 10 cases. Clinical symptoms improved in eight patients and stable in three patients. There were no recurrences during the follow-up period. Postoperative morbidities included one pseudomeningocele and one transient dysphagia with dysarthria. Conclusion : Ventral FM meningiomas can be removed gross totally using a posterior approach without fat lateral approach. The arachnoid membrane can then be exploited as an anatomical barrier. However, this approach should be taken with a thorough understanding of its anatomical limitation.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.463-471
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• 2001

Objective : The authors reviewed 51 patients of spinal cord tumor located at the craniovertebral junction and high cervical area to determine which factors influenced resectability, complications, and postoperative outcomes. Methods : Radiological examinations, clinical data, and operation notes were evaluated, and additional follow-up information was obtained from outpatient examinations. The mean follow-up period was 3.5 years Results : The most common neurological findings were motor deficit(72.5%) and sensory change(47.1%). There was no clinical finding that is considered as pathognomic. Meningioma(18 cases, 35.3%) was the most common tumor in this region. Total removal was achieved in 45 patients. There was no surgical mortality. Immediate postoperative motor weakness were encounted in 11 cases(21.6%) which improved in long term followup except two patients. Conclusions : The location and relationship of the tumor to surrounding struncture determine its resectability. Postoperative results were related to the preoperative neurological status and pathological findings.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.264-267
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• 2011

A 50-year-old man presented bilateral hypesthesia on and below the T6 dermatome and paresthesia. Magnetic resonance imaging (MRI) showed an intraspinal extradural tumor, which located from the 6th thoracic vertebral body to the upper margin of the 7th vertebral body, continuing dumbbell-like through the intervertebral foramen into the right middle thorax suggesting a neurogenic tumor (neurofibroma or neurilemmoma). With the patient in a prone position, we exposed and excised the tumor via a one stage posterior approach through a hemi-laminictomy of T6. Histologic examination showed a grade 1 meningothelial meningioma, according to the World Health Organization classification. Initially, we assumed the mass was a schwannoma because of its location and dumbbell shape. However, the tumor was actually a meningioma. Postoperatively, hypesthesia resolved completely and motor power of the leg gradually full recovered. A postoperative MRI revealed no evidence of residual tumor.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.300-304
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• 2007

Objective : We report experiences and clinical outcomes of 61 cases with spinal canal meningiomas from January 1970 through January 2005. Methods : Thirty-eight patients were enrolled with follow-up duration of more than one year after surgery. There were 7 male and 31 female patients. The mean age was 52 years (range, 19 to 80 years). All patients underwent microsurgical resection using a posterior approach. Results : Twenty-nine (79.4%) cases experienced clinical improvement after surgery. The extent of tumor resection at the first operation was Simpson Grade I in 10 patients, Grade II in 17, Grade III in 4, Grade IV in 6, and unknown in one. We did not experience recurrent cases with Simpson grade I, II, or III resection. There were 6 recurrent cases, consisting of 5 cases with an extent of Simpson grade IV and one with an unknown extent. The mean duration of recurrence was 100 months after surgery. Radiation therapy was administered as a surgical adjunct in four patients (10.5%). Two cases were recurrent lesions that could not be completely resected. The other two cases were malignant meningiomas. No immediate postoperative death occurred in the patient group. Conclusion : We experienced no recurrent cases of intraspinal meningiomas once gross total resection has been achieved, regardless of the control of the dural origin. Surgeons do not have to take the risk of causing complication to the control dural origin after achieving gross total resectioning of spinal canal meningioma.