Spinal clear cell meningioma without dural attachment: a case report and literature review

Abstract

Clear cell meningiomas (CCM) are a very rare histologic subtype of meningioma usually affecting younger patients. The reported data on spinal CCM are extremely rare. Until today, only 89 cases have been reported. Furthermore, CCM without dural attachment is even rarer since only 19 cases have been reported in English literature. In this article, we present the twentieth case of a spinal CCM without dural attachment. Our patient was a 58-year-old female who was presented with pain in her lower back and bilateral sciatica for 6 months. Magnetic resonance imaging showed an intra-dural well-demarcated lesion at L3. Via a posterior approach, total resection was possible due to the lack of dural adhesion of the tumor. Histologic diagnosis was clear cell meningioma.

Keywords: Clear cell meningioma; Dural attachment; Lumbar; Resection; Spine.

Fig. 1

Intra-dural mass at L3 isointense on T1 on sagittal and axial section (A, B) and after injection of gadolinium (C) and hyperintense on T2 on sagittal and axial section (D, E).

Fig. 2

Pathological features of spinal clear cell meningioma: Tumor cells in classical CCM area with distinct cellular outlines and abundant clear cytoplasm (Black arrow) with no mitosis and no necrosis area (A: H&E staining with original magnifications x 100; B: H&E staining with x400).