TITLE:
Dorsal Psammomatous Meningioma Revealed by Sciatica Case Report
AUTHORS:
Daouda Wague, Maguatte Gaye, Cheikh Ndiaye Sy, Mouhamet Cisse, Souleymane Diallo, Youssouf Sakho
KEYWORDS:
Meningioma, Dorsal, Sciatica, Psammomatous
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.5,
May
28,
2021
ABSTRACT: Introduction: Meningiomas are benign tumors most localized in brain. Intraspinal
meningiomas are rare and may have an intra or extradural topography. We report
the case of a dorsal psammomatous meningioma revealed by sciatica. Case
description: We present a 58-year-old female hospitalized for bilateral
painful and disabling L5 sciatica rebellious to medical treatment and
physiotherapy. At physical examination, she presented a lumbar spinal syndrome
without root deficit. MRI (Magnetic Resonance Imaging) showed a borderline lumbar canal with a
paramedian L4-L5 herniated disc. She undergone a first surgery a L4 decompressive
laminectomy and there was no postoperative complications. The follow-up was marked by partial pain
regression. Three months later, after a fall she presented low back pain and
progressive worsening gait troubles. A MRI was realized and shown L3-L4, L4-L5
duct narrowing. A second surgery a L3 and L5 decompressive laminectomy was
performed. The postoperative follow up was characterized by the worsening of the motor deficit to 2/5 associated with brisk
osteotendinous reflexes. A medullary MRI was realized, showing an intradural
but extra-medullary compressive lesion facing D1-D2. The
indication of tumor removal was made and complete resection was performed. She
totally recovered from the deficit and the pain. The pathology report showed a
psammomatous meningioma. Conclusion: This case report emphasizes the
atypical clinical presentation of spinal meningiomas and the importance of a
meticulous neurological examination to avoid misdiagnosis.