Article Figures & Data
Figures
- Fig 1.
A dumbbell-shaped epidural psammomatous meningioma in 43-year-old woman at C1–2. Sagittal CT image (A) reveals the dura from the occiput to C2 thickened with patchy calcification. The ossification of the posterior longitudinal ligament is seen in the C2–3 segment. Axial CT image (B) shows a high-intensity epidural mass formed at C1–2 with adjacent bone thinned. Axial T2-weighted image (C) shows that the soft mass has low signal intensity compared with that of the spinal cord. Postcontrast T1-weighted sagittal (D) image demonstrates a diffusely enhancing dorsal and ventral dura extending over 2 vertebral segments. Postcontrast T1-weighted coronal image (E) shows an epidural mass with moderate enhancement and C1–2 intervertebral foramen enlargement. The spinal cord was markedly displaced, and intradural invasion can be seen. F, Photomicrograph of the epidural component shows a psammomatous meningioma characterized by the presence of psammoma bodies (arrows). H&E, original magnification, ×200.
- Fig 2.
En plaque epidural psammomatous meningioma in a 48-year-old woman at C2–4. Sagittal CT image (A) reveals the dural calcification at the C2–4 spinal segments. Sagittal T2-weighted image (B) shows that the epidural lesion is isointense. Axial T2WI (C) shows that epidural soft mass encircles spinal cord as a half ring. Axial postcontrast T1-weighted image (D) shows that the homogeneously enhanced epidural mass encircling the spinal cord from the ventral and dorsal sides. Sagittal postcontrast T1-weighted image (E) shows homogeneous enhancement of the ventral and dorsal dura, and the dural tail sign can be seen. Coronal postcontrast image (F) shows homogeneous enhancement of the epidural mass that compresses the spinal cord. G, Photomicrograph of a psammomatous meningioma is characterized by the presence of psammoma bodies (arrow). There are meningothelial cells (long arrow) and a small number of fibrous components. H&E, original magnification, ×200.
- Fig 3.
Fusiform epidural angiomatous meningioma in a 59-year-old woman at T4–6. Sagittal T1-weighted MR image (A) shows the epidural mass with signal intensity like that of the spinal cord. The subarachnoid space is obliterated at the level of the mass. Sagittal T2-weighted MR image (B) shows that the mass has heterogeneous signal intensity and the spinal cord is compressed with edema. Sagittal T1-weighted postcontrast image (C) reveals homogeneous enhancement of the extradural meningioma, and the dural tail sign can be seen. Photomicrograph shows that this tumor is composed of islands of meningothelial cells with many vascular vessels (thin arrows, D). H&E, original magnification, ×200.
Tables
Case Sex Age (yr) Location Shape Calcification 1 F 20 C1–2 Dumbbell − 2 F 43 C1–2 Dumbbell + 3 F 40 C6–7 Dumbbell − 4 F 76 C2–3 Dumbbell + 5 M 46 C2–5 En plaque + 6 F 48 C2–4 En plaque + 7 F 43 C4–6 En plaque + 8 F 46 C2–4 En plaque + 9 M 36 C1–4 En plaque + 10 M 30 C2–4 En plaque − 11 M 38 C3–5 En plaque − 12 F 47 C2–7 En plaque − 13 F 50 T9–10 En plaque + 14 F 59 T4–6 Fusiform − Tumor Type/Imaging Findings En Plaque Dumbbell Fusiform Total Percentage Tumor location Cervical spine 8 4 0 12 86% Thoracic spine 1 0 1 2 14% Well-defined boundary 0 1 1 2 14% Dural thickening 8 3 0 11 79% Dural calcification 6 2 0 8 57% Adherence to nerve roots 7 4 0 11 79% Neural foramen enlargement 6 4 0 10 71% Bone erosion 2 3 0 5 36% Intradual invasion 4 4 0 8 57% Epidural mass formation 7 4 1 12 86% Spinal cord compression 8 3 1 12 86% T1WI Isointensity 6 2 0 8 57% Hypointensity 3 2 1 6 43% T2WI Isointensity 3 2 0 5 36% Hypointensity 5 2 0 7 50% Heterogeneous 1 0 1 2 14% Dural tail sign 8 4 1 13 93% Tumor enhancement Moderate 2 3 0 5 36% Marked 7 1 1 9 64% Pathologic type Psammomatous 7 3 0 10 71% Meningothelial 1 1 0 2 14% Transitional 1 0 0 1 7% Angiomatous 0 0 1 1 7% Case Treatment Follow-Up (mo) Results 1 Subtotal resection 120 Recurrence 2 Subtotal resection 5 Recurrence 3 Complete resection 60 No recurrence 4 Subtotal resection 156 Recurrence 5 Subtotal resection 68 No progress 6 Complete resection 79 No recurrence 7 Subtotal resection 192 Recurrence 8 Subtotal resection 48 No progress 9 Subtotal resection 49 No progress 10 Subtotal resection 36 Recurrence 11 Subtotal resection No No MRI follow-up 12 Subtotal resection 7 Recurrence 13 Subtotal resection 180 Recurrence 14 Complete resection 4 No recurrence
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