Unusual clinical presentation of cervical extradural meningioma detected with neuromuscular ultrasound: A case report

Hsieh,Pei-Chen; Lu,Johnny Chuieng-Yi; Huang,Shih-Chiang; Toh,Cheng Hong; Kuo,Hung-Chou

doi:10.3892/etm.2024.12493

Unusual clinical presentation of cervical extradural meningioma detected with neuromuscular ultrasound: A case report

Authors:
- Pei-Chen Hsieh
- Johnny Chuieng-Yi Lu
- Shih-Chiang Huang
- Cheng Hong Toh
- Hung-Chou Kuo
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Affiliations: Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan 333, Taiwan, R.O.C., Department of Plastic and Reconstructive Surgery, Division of Reconstructive Microsurgery, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan 333, Taiwan, R.O.C., Department of Anatomical Pathology, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan 333, Taiwan, R.O.C., Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan 333, Taiwan, R.O.C.
Published online on: March 19, 2024 https://doi.org/10.3892/etm.2024.12493
Article Number: 205
Copyright: © Hsieh et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Extradural meningiomas are rare in the cervical region. A total of 70‑77% of reported cases have occurred in the thoracic region. Tumors that occur in the cervical region may invade the adjacent nerve root and brachial plexus. Typically, diagnoses of extradural meningioma are made after patients present with signs of myelopathy, such as progressive paresis and numbness. In the current study, a 64‑year‑old male patient presented with neck pain, numbness and mild weakness in the left hand over a 6‑month period. The general neurological examination was unremarkable, except for mild grasping weakness on the left side. Needle electromyography revealed complex repetitive discharges in the left 5 and 6th cervical paraspinal muscles. Neuromuscular ultrasound revealed a lesion over the left 7th cervical root, which enabled the early detection of an extradural meningioma before notable focal neurological defects developed. The patient underwent a subtotal tumor excision, followed by radiotherapy for residual tumor. Histopathological examination confirmed atypical meningioma.

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