Pure posterior chordoid foramen magnum meningioma: A case report and review of literature

Abstract

Introduction and importance: Meningiomas are extra-axial central nervous system (CNS) tumors that arise from the arachnoid cells of the dura mater. Only 1.8-3.2% of all meningiomas are located at foramen magnum (FM) and pure posterior FM meningioma are very rare. The diagnosis of malignancy in patients with meningiomas has been a controversial issue. Only a histological study can confirm this situation.

Case presentation: We report a case of A 52-year-old female presented with a history of neck pain with progressive spastic quadriparesis.

Clinical discussion: Magnetic resonance imaging MRI T1 and T2 weighted images revealed well-defied pure posterior foramen magnum Lesion. Although the lesion was very sticky to neurovascular components. Simpson grade I was achieved. Histopathology revealed Chordoid meningioma. The patient had a dramatic recovery.

Conclusion: Although choroid meningioma is usually well circumscribed, sticky tumors should be suspected. Recurrence of Chordoid meningioma should be suspected. Total excision should be achieved and routine follow-up should be informed. Reports about chordoid meningioma aren't common, but reports on choroid foramen magnum meningioma are very rare. The opportunity to give the patient a symptom-free and normal life should not be missed in such cases.

Keywords: Chordoid meningioma; Foramen magnum meningioma (FMM); Pure posterior FMM.

Fig. 1

A: Post-contrast T1 weighted axial image, B: Post-contrast T1 weighted sagittal image: magnetic resonance imaging (MRI) showing pure posterior placed, inhomogenously enhancing dural based lesion measures 2 *2.5 CM in the foramen magnum (Blue arrow). C: T2 weighted axial image shows iso-tense lesion in the foramen magnum T1weighted sagittal image shows hypo-tense lesion in the foramen magnum. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)

Fig. 2

Post-operative T2 -MRI (A: sagittal, B Axial) after 3 months shows no residual tumor. Red arrow indicates Normal spinal cord surrounding by CSF. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)