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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(01): 44-50
DOI: 10.4103/ajns.AJNS_385_20
Review Article

A giant nondural-based lumbosacral clear cell meningioma mimicking schwannoma: A case report and review of the literature

Surendra Gupta
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Nitish Nayak
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Charandeep Gandhoke
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Rakesh Gupta
1   Department of Pathology and Laboratory Medicine, AIIMS, Raipur, Chhattisgarh
,
Anil Sharma
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Prashant Singh
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Raghvendra Sharma
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
,
Lokesh Nehete
Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh
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Spinal clear cell meningiomas (CCMs) are rare and dural-based lesion usually affecting the younger population. We report the rare case of giant nondural-based spinal CCM mimicking schwannoma and review the literature. A literature search was performed at PubMed and Embase until January 1, 2020. A total of 19 cases of nondural-based spinal CCM was reported. The following relevant data were extracted: authors, publication year, patient and tumor characteristics, treatment, and outcome. The mean age of the presentation was 20.58 years. Twelve (63.16%) were female and seven patients (36.84%) were male. The most common location was lumbosacral region 15 (79%). Fifteen (79%) tumors had cranio-caudal dimension ≤2 vertebral level, and only four (21%) tumors had dimension ≥2 vertebral level. Gross total resection (GTR) was performed in 18 (95%) patients and subtotal resection (STR) in 1 patient. Recurrences were reported in five (26.14%) patients. Four of them showed recurrences within 6 months; earliest at 2.3 months in the patient had undergone STR. Our patient is 19-year-old male diagnosed with a lumbosacral intradural lesion. Craniocaudal dimension is ≥2 vertebral level shows the foraminal extension and vertebral scalloping. GTR is performed. Intraoperatively, the tumor has foraminal extension and shows attachment with right S1S2 nerve root. No dural attachment is found. Six-month follow-up magnetic resonance image shows no evidence of disease. Nondural-based spinal CCMs are extremely rare and should be kept as a differential diagnosis in young patients with giant intradural tumor, and whose radiological features suggesting of schwannoma. It affects young patients and usually involves more than one vertebral level. The chances of recurrences and metastasis are always high even after GTR; hence, close follow-up of the entire neuraxis is warranted.

Key-words:

Clear cell meningioma - intradural tumor - nondural-based meningioma - schwannoma - spinal meningioma

Financial support and sponsorship

Nil.




Publication History

Received: 05 August 2020

Accepted: 28 December 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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