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THORACIC MENINGIOMA

A 48-year-old lady presented with a 1-year history of on-and-off back pain. The pain was worse at night, especially when the patient lay flat on her back. She would have to turn on her side before she would be able to sleep. A few weeks ago, the patient also noted progressive numbness and weakness in both legs, prompting consult.

On examination, the patient was unable to walk and was seated in a wheelchair. There was weakness of Grade 3/5 in both legs, which meant that the patient was able to lift her leg against gravity but not against resistance. There was numbness starting at the level of her chest going down to her legs.

MRI of the thoracic spine showed a well-defined tumor compressing the spinal cord at the upper thoracic area (upper back).

The patient underwent surgery for removal of the tumor, which turned out to be a meningioma. Meningiomas are benign tumors arising from the covering of the brain and spinal cord. They are seen more often in women and at the thoracic level, if they occur in the spine. As this case shows, meningiomas can be found not only in the brain, but also in the spine.

The patient improved after surgery. Her back pain became much less and she is now able to lie down flat on her back without experiencing pain. Her leg weakness gradually improved, as well as the numbness. Once she had recovered from the surgery, she underwent physiotherapy to help her regain strength and function.

     
 
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