Unusual Appearance of an En Plaque Meningioma of the Cervical Spinal Canal: A Case Report and Literature Review


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Abstract

Study Design. A case report of a patient with cervical spinal cord and nerve root compression caused by a meningioma en plaque together with calcification of the posterior longitudinal ligament is presented, with a review of the literature.Objective.To present the diagnosis of a calcified dural meningioma en plaque, with extradural extension into the ligamentum flavum, in a woman with cervical myelopathy and neuropathy.Summary of Background Data .This case demonstrates that the cervical spine can be involved in dural meningioma en plaque with calcifications, in a manner mimicking ossification of the ligamentum flavum, which has never been previously reported.Methods.A patient presenting with cervical cord and nerve root compression caused by ossification of the posterior longitudinal ligament and a concurrent calcified dural meningioma en plaque was treated surgically and has made a gradual recovery. Imaging studies, surgical findings, and histopathologic evaluation were analyzed to support the diagnosis.Results.At surgery, ossification of the posterior longitudinal ligament was noted, along with a calcified lesion involving the posterior cervical dura and the adjacent ligamentum flavum. A calcified meningioma was diagnosed by histopathologic examination of the dural-based lesion.Conclusion.Although previously not described, the diagnosis of calcified dural meningioma en plaque should be considered in all patients presenting with spinal cord and/or nerve root compression, even at cervical levels. Although ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum are more common etiologies of partially circumferential spinal calcification, dural-based meningiomas with extension into the surrounding ligaments demand early recognition because they can be associated with a poorer prognosis.

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