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脊髓脊膜瘤多发生于中年女性胸段,但可沿椎管发生在别处。临床上常表现为脊髓或神经根受压体征,常为硬膜内髓外肿瘤,硬膜外脊膜瘤也有描述,对所有报告的病例近已有人作过文献复习,除1例外所有肿瘤都在椎管内。本文报告一例异位于C_2平面脊膜瘤,主要位于椎管外。患者51岁女性,颈部右侧乳突后下方有一无疼性肿块。四月前,注意到有一肿块,位于枕骨下部及颈后三角区顶端,质较硬,耳、头皮、咽部均无异征,颅骨及颈椎X 片均正常。两年后,颈部开始疼痛,向右看时更重,肿物扩大而住院。活检为梭形细胞伴有砂粒样体的肿瘤,周围侵及一淋巴结。于是转到神经外科,神经系统检查正常。颈椎侧位片C_1棘突后有轻微钙化。选择性右椎动脉导管造影有明显血管性肿瘤,主要由右侧椎动脉,位于C_1和C_2处的脊膜支供血。手术:
Spinal meningioma occurs most often in middle-aged female thoracic segments but can occur elsewhere along the spinal canal. Clinically, there are often signs of spinal cord or nerve root compression, often extradural extramedullary tumors, epidural meningioma also described, for all reported cases have been reviewed in the literature, with the exception of all tumors except 1 In the spinal canal. This article reports one case of an anomalous C2 planar meningioma, mainly located outside the spinal canal. A 51-year-old woman had a painless mass below the right mastoid process of the neck. Before April, a mass was noted, located in the lower part of the occipital bone and at the top of the posterior cervical triangle. It was hard and the ear, scalp, and pharynx were all without signs. The skull and cervical spine were normal. Two years later, the neck began to feel pain, and when he looked to the right, he was heavier, and the tumor expanded and was hospitalized. The biopsy was a spindle cell accompanied by sand-like tumors that invaded a lymph node. Then I went to neurosurgery and the nervous system was normal. Lateral cervical spine C_1 spinous process has a slight calcification. Selective right vertebral arterial angiography showed significant vascular tumors, mainly from the right vertebral artery, the branch of the spine at C_1 and C_2. surgery: