PMC4173215_01
MRI findings in Case 1, showing an extradural lesion extending from C3 to C6 vertebral levels. The lesion appears isointense on T1-weighted images [(a) axial, (e) sagittal], hyperintense on T2-weighted images [(b) axial, (f) sagittal], and exhibits intense enhancement on contrast administration [(c) axial, (g) sagittal]. Postoperative contrast-enhanced MRI [(d) axial, (h) sagittal] at 1 year follow-up showing small residue laterally on the left side, encircling the vertebral artery without any compression on the dural sac
SNI-5-291-g001.jpg
PMC4173215_01_SNI-5-291-g001.jpg
F1
The lesion was iso- to hypointense on T1-weighted as well as T2-weighted MR images and showed intense contrast enhancement [Figure 1]. The patient had complete resolution of symptoms and follow-up radiology at 1 year showed small residue in the region of the lateral process encircling the vertebral artery, but without any dural compression [Figure 1d and h].
PMC4173215_02
MRI findings in Case 2, showing an extradural lesion extending from D3 to D6 vertebral levels. The lesion is isointense on T1-weighted images [(a) axial, (e) sagittal], hyperintense on T2-weighted images [(b) axial, (f) sagittal], and intensely contrast enhancing [(c) axial, (g) sagittal]. Postoperative contrast-enhanced MRI [(d) axial, (h) sagittal] at 3 months follow-up shows gross total excision of the tumor
SNI-5-291-g002.jpg
PMC4173215_02_SNI-5-291-g002.jpg
F2
An urgent MRI of the thoracic spine showed an extradural en plaque spinal lesion located posterolateral to the spinal cord, pushing the dura anteriorly [Figure 2]. It arose primarily from the left posterolateral corner of the spinal canal, and extended predominantly dorsally but also ventrally in relation to the cord [Figure 2a-c]. Follow-up MRI showed no evidence of residual or recurrent lesion [Figure 2d and h].
(a) Intraoperative image of the fleshy extradural meningioma (arrow) on the right side of the thecal sac, with the shining white dura (dashed arrow) under the tumor. (b) Photomicrograph (HE stain) showing a meningothelial meningioma arranged in syncytium and whorling pattern. Few psammoma bodies are also present
SNI-5-291-g003.jpg
PMC4173215_02_SNI-5-291-g003.jpg
F3
Histopathology was unequivocal for meningioma [Figure 3b]. At surgery, the tumor could be peeled off the dura, enabling a total excision [Figure 3a].