Completely ossified thoracic intradural meningioma in an elderly patient: A case report and literature review

Medicine (Baltimore). 2020 Jun 19;99(25):e20814. doi: 10.1097/MD.0000000000020814.

Abstract

Rationale: Spinal meningioma is the second most common spinal neoplasm that commonly occurs in middle-aged women. As a rare histological variation of meningioma, completely ossified meningioma (OSM) and its standard surgical strategies have been reported. However, the surgical outcomes of elderly OSM cases (age >70) are less investigated. Herein, we intend to present an elderly OSM case and review the elderly OSM cases in published literatures.

Patient concerns: An 85-year-old female presented with 10-year history of back pain and developed radiating pain on her left lower extremity within the last 2 weeks.

Diagnoses: A magnetic resonance imaging scan revealed an intradural tumor at the T11 level. A computed tomography scan demonstrated that the mass was completely ossified and had distinct borders (D-F). In a dynamic contrast-enhanced magnetic resonance imaging scan, the mass presented as a lateral intradural extramedullary tumor with abundant blood supply ().

Interventions: The patient underwent en bloc intradural tumorectomy via posterior approach.

Outcomes: After surgery, the patient's pain was relieved. However, the patient spent another 3 weeks in hospital due to a series of post-surgery complications, including hypostatic pneumonia, pulmonary heart failure, hydrothorax in both thoracic cavities, hypoproteinemia, and deep venous thrombosis on both of her legs. The complications recovered after 3-weeks treatment. In 1-year follow up, no additional symptom was found and the patient was recurrence free.

Lessons: Our report indicated that the surgical outcome can be satisfying in elderly OSM patients, while the post-operative complications frequently occur due to the poor physical condition of elderly patients. As a result, treatment of peri-operative complications of elderly OSM patients also deserves greater attention along with surgical resection.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Meningioma / diagnosis*
  • Meningioma / diagnostic imaging
  • Meningioma / pathology
  • Meningioma / surgery
  • Ossification, Heterotopic / diagnosis
  • Ossification, Heterotopic / diagnostic imaging
  • Ossification, Heterotopic / pathology
  • Ossification, Heterotopic / surgery
  • Spinal Cord Neoplasms / diagnosis*
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / surgery
  • Thoracic Vertebrae
  • Tomography, X-Ray Computed