J Korean Soc Spine Surg.  2011 Dec;18(4):263-267. 10.4184/jkss.2011.18.4.263.

Synchronous Development of Spinal Cord Tumor: Meningioma and Schwannoma: A Case Report

• Min HJ
• Kim JS
• Seok JP

• KMID: 1448006
• DOI: http://doi.org/10.4184/jkss.2011.18.4.263

Abstract

STUDY DESIGN: A case report.
OBJECTIVES
To report a case of thoracic spinal meningioma and lumbar spinal schwannoma found in one patient. SUMMARY OF LITERATURE REVIEW: patients with different types of spinal cord tumor, specifically meningioma and schwannoma, are rare in medical literature.
MATERIALS AND METHODS
A 66 year-old female presented with complaints of walking difficulty. She had masses on the thoracic and lumbar spine and underwent open excision and biopsy.
RESULTS
Three months after operation, the patient could walk independently and no recurrence was found at 1-year follow up.
CONCLUSIONS
Thoracic spinal meningioma and lumbar spinal schwannoma occurring in one individual were treated successfully by operative management.

Keyword

Spinal cord; Meningioma; Schwannoma

MeSH Terms

Female
Humans
Meningioma
Neurilemmoma
Recurrence
Spinal Cord
Spinal Cord Neoplasms
Spine
Walking

Figure

• 

  Fig. 1. (A) Preoperative Gd-enhanced sagittal MRI demonstrated that the mass shows high signal intensity on T3-4 level. (B) Preoperative Gd-enhanced sagittal MRI demonstrated that the mass shows heterogeneous high signal intensity on L1-2 level. (C) Low signal intensity change of L1-2 mass shows on T2-weighted sagittal MRI. (D) Preoperative Gd-enhanced axial MRI of T3-4 mass demonstrated that the mass has a dural tail sign. (E) Preoperative Gd-enhanced axial MRI of L1-2 mass shows heterogeneous signal intensity.

• 

  Fig. 2. T-spine CT scan image shows a ossification within the mass.

• 

  Fig. 3. Thoracic mass was excised by performing longitudinal dural incision. The mass was attached to dural sac but excised without dural defect, measuring 1.2x0.8x0.6 cm

• 

  Fig. 4. Lumbar mass which containing a intermingled nerve fiber was yellowish, well capsulated and cylinderic shape, measuring 4.1x1.9x1.7 cm.

• 

  Fig. 5. (A) Photomicrograph of tumor of T-spine showing characteristic meningeal whorls (H&E, x200) (B) Photomicrograph of the tumor of L-spine showing compact cellular Antoni type A and loose myxoid Antoni type B (H&E, x200)

• 

  Fig. 6. Gd-enhanced & T2-weighted T-spine MR images(A,B) and T2-weighted L-spine MR images(C,D,E) of same patient 1year later show no recurrence of tumor.

Reference

1. Solero CL, Fornari M, Giombini S, et al. Spinal meningiomas: review of 174 operated cases. Neurosurgery. 1989; 25:153–160.

2. Chen HJ, Lui CC, Chen L. Spinal epidural meningioma in a child. Child's Nerv Syst. 1992; 8:465–7.

3. Calogero JA, Moossy J. Extradural spinal meningiomas. J Neurosurg. 1972; 37:442–7.

4. Nittner K. Spinal meningiomas, neurinomas, and neurofibromas and hourglass tumors. Vinken P, Brunyn B, editors. Handbook of Clinical neurology. New York: American Elsevier;1976. p. 177–322.

5. Chung JY, Kim HJ, Seo HY, Lee JJ. Diverse characteristics of spinal nerve sheath tumor on magnetic resonance images. J Korean Soc Spine Surg. 2009; 16:38–45.

6. Bloomer CW, Ackerman A, Bhatia RG. Imaging for spinal tumors and new applications. Top Magn Reson Imaging. 2006; 17:69–87.

7. Friedman DP, Tartaglino LM, Flanders AE. Intradural schwnnomas of the spine: MR findings with emphasis on contrast-enhancement characteristics. AJR. 1992; 158:1347–50.

8. Demachi H, Takashima T Kadoya M, et al. MR imaging of spinal neurinomas with pathologic correlation. J Comput Assist Tomogr. 1990; 14:250–4.

9. Nishiura I, Koyama T, Tanaka K, Aii H, Amano S. The occurrence of different types of spinal tumors in one patient. A case report and review of the literature. Neurochirurgia. 1989; 32:52–5.