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Rivista di Chirurgia
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 June;27(3):183-7
Cervical dumbbell meningioma in a patient with neurofibromatosis type 2: a case report and review of literature
Umebayashi D., Hara M., Nishimura Y., Nakajima Y., Wakabayashi T.
Department of Neurosurgery, Nagoya University School of Medicine, Aichi, Japan
Although schwannomas sometimes appear as dumbbell shaped tumors in the spine, a dumbbell meningioma is quite rare. A few cases of dumbbell meningioma, however, have been reported in neurofibromatosis patients. Unfortunately, it is difficult to distinguish such a tumor from a schwannoma, the most common spinal tumor in neurofibromatosis. In this study, we report a case of dumbbell meningioma and provide a review of literature regarding this type of cancer. In the case presented here, surgical removal of the dumbbell shaped tumor was scheduled in the first operation. The extradural tumor was completely resected, while the intradural tumor, which was not observed during the operation, was left in the patient. Pathological study revealed that the tumor was a meningioma, and postoperative magnetic resonance imaging exposed the residual tumor in the intradural space. Further, the patient suffered from refractory atlantoaxial rotatory subluxation after surgery. As a result, residual tumor removal and occipitocervical fixation were performed after reducing the subluxation. Complete resection of the tumor was successfully achieved. The patient’s condition and her cervical alignment improved following surgery. Moreover, her atlantoaxial rotatory subluxation has not recurred. Dumbbell meningioma is quite rare, but the incidence of the tumor among neurofibromatosis patients may be relatively high as compared to that in non-neurofibromatosis patients, indicating a possible association. Thus, the possibility of a meningioma should be considered if a dumbbell shaped spinal tumor is observed, especially in neurofibromatosis patients.