Circumferential intradural meningioma of the thoracic spine: Case report and literature review

Background: Meningiomas are common intradural extramedullary spinal tumors with a predilection for the thoracic spine. They are mostly benign (90%), with only a few showing malignant potential. However, circumferential intradural meningiomas surrounding the spinal cord are exceptionally rare. Here, we present a 40-year-old patient with a T6-T7 circumferential lesion who underwent surgery. In addition, we reviewed three similar cases previously reported in the literature. Case Description: A 40-year-old female presented with paraparesis. Imaging demonstrated a T6-T7 thoracic circumferential intradural lesion, considered to most likely be a meningioma. At surgery, the posterolateral portion of the tumor was removed, but there was residual ventral disease. The tumor recurred several years later, and was again partially removed, now leaving her with a residual neurological deficit. Three similar cases of circumferential meningiomas, one cervical and two thoracic, were reported from the literature. Conclusion: Circumferential meningiomas pose unique and significant surgical challenges, particularly since resection of the posterolateral components is feasible, but some tumor may have to be left ventrally to avoid injury to the anterior spinal artery, that may recur.