PMC9755702_01
(a-c) Preoperative images of the patient: CT of the head and cervical spine showing no obvious abnormalities (a), MRI showing that the lesion extends from the tentorium cerebella to the seventh cervical spinal canal, enveloping the cervical spinal cord. The lesion is isointense on T1-weighted images and slightly longer range on T2-weighted images, enhanced remarkably and homogeneously after infusion of contrast administration (arrows) (b and c). (d-f) Postoperative images, CT showing changes in the dural lesions after resection (d). Postoperative MRI showing that a part of the thickened dura of the foramen magnum and C1 vertebral body is nodular, while nodular signals in the other regions are significantly reduced (arrows) (e and f).
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After admission, a computed tomography (CT) scan of the head and cervical spine revealed no obvious abnormalities (Figure 1a); however, magnetic resonance imaging (MRI) revealed multiple abnormal signals in the tentorium cerebelli, paradural area beside the saddle, soft tissue area beside the transverse process of the atlantoaxial vertebra, and the C1-7 vertebral canal, leaving the cervical spinal cord enveloped and pressed (Figure 1b and c). After surgery, the patient's muscle strength gradually improved, and reexamination with CT and MRI (Figure 1e and f) suggested that most of the lesions had been removed (Figure 3).
Photomicrographs demonstrating the histological features of the mass. Hematoxylin and eosin staining (magnification, x100, x400) (a and b) showing lymphoplasmacytes infiltrating the tumor stroma, overshadowing the meningioma component (arrows). Immunohistochemistry testing (c) showing epithelial membrane antigen positivity (arrows), (d) PR positivity (arrows), (e) S-100 positivity (arrows), and (f) vimentin positivity (arrows).
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Postoperative pathological examination was as follows (Figure 2): pathological visualization, C2-6 subdural space occupation: multiple grayish-yellow tissues with a total size of 4.53 cm x 0.5 cm; microscopically, C2-6 subdural space occupation combined with clinical and immunomarkers consistent with meningioma involvement (WHO grade
Timeline of the case presentation.
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After surgery, the patient's muscle strength gradually improved, and reexamination with CT and MRI (Figure 1e and f) suggested that most of the lesions had been removed (Figure 3).