Purely epidural spinal meningioma mimicking metastatic tumor: case report and review of the literature.

Methods: Case report. Objective: To report a rare case of purely extradural spinal meningioma in a patient with previous history of malignant disease and to discuss the potential pitfalls in differential diagnosis and treatment of intraspinal extramedullary masses.

Background: Spinal meningiomas located purely in the extradural space are rare, and they may easily be confused with malignant neoplasms that are much more common in this location.

Methods: An asymptomatic intraspinal extramedullary mass in the thoracolumbar region was detected by magnetic resonance imaging in a 75-year-old woman with previous history of malignant disease.

Results: The purely extradural lesion was completely excised via a dorsal approach. The intraoperative and postoperative histologic examination revealed a meningioma. The patient is symptom free 18 months after surgery without radiologic recurrence.

Conclusions: Extradural spinal meningiomas may mimic metastatic disease. Attention needs to be drawn to this dangerous preoperative and intraoperative misinterpretation, which may easily entail an inadequate therapy. Intraoperative histology is mandatory for optimal surgical decision-making.