Case ReportImmunohistochemical findings of multiple ossified en plaque meningiomas in the thoracic spine
Introduction
Meningioma of the spinal cord is a common intradural extramedullary neoplasm, comprising 25–43% of all spinal cord tumours that emanate from the meninges, with the highest frequency from the anterolateral aspect of the arachnoid.[1], [2] Psammomatous meningothelial meningioma is an infrequent lesion that appears as a calcified mass on plain radiograph or CT scan.[3], [4], [5] The ossified spinal meningioma en plaque[3], [6] is extremely rare, with a reported incidence of 1–5% of all spinal meningiomas.[3], [7] However, the mechanism responsible for the ossification process remains poorly understood. We describe a patient with multiple ossified spinal en plaque meningiomas, and report the immunohistochemical findings.
Section snippets
Case report
A 76-year-old woman presented with a 2-year history of painful muscle weakness and numbness in both legs, with right-side predominance. She also complained of fatigue, a sensation of heaviness, weakness of both lower extremities and urinary incontinence. Walking increased radicular-type leg pain, which resembled spinal cord intermittent claudication.
Discussion
Psammomatous spinal meningioma is reported to exhibit a low growth tendency.[1], [7] Although some researchers2 have suggested that hyperostosis of a spinal meningioma is linked to a cranial origin, ossified spinal meningioma en plaque is extremely rare and the mechanism of ossification remains elusive.[7], [9], [10]
Spinal meningioma is believed to grow from the arachnoidal cells that differentiate from neural crest cells. Unlike the common encapsulated meningioma that develops into a “floating
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