Intraspinal meningioma in a 101-year old: should age determine the aggressiveness of intervention?

Background: Intraspinal meningiomas are less frequent in occurrence as compared with their intracranial counterparts. Typical presentation is onset of new spinal pain followed by other deficits in the sixth decade of life. Although total surgical removal is the optimum treatment, various tumor- and patient-related factors can determine the aggressiveness of the surgical endeavor. We present our experience of diagnosis and management of cervical intraspinal meningioma in the oldest reported patient (101 years) with an atypical clinical presentation and remarkable dissociation between clinical and radiologic findings.

Method: The patient, a 101-year-old woman, experienced progressive weakness in her legs. Motor examination revealed no definite weakness. There was stocking type sensory loss to just below the knees bilaterally. The MRI of the cervical spine showed an enhancing mass anterolateral to the cord at the region C7 through T1. It markedly compressed the cord.

Result: The tumor was removed in total, and the dural attachment was thoroughly coagulated.

Conclusion: The presented experience supports the belief that, in spinal meningiomas, a good clinical outcome can be expected even in patients who may be less than perfect candidates for an aggressive surgical approach.