Giant cervicothoracic extradural meningioma involving the brachial plexus: A case report

Background: Spinal meningiomas account for 25% of spinal tumors, with the majority being intradural neoplasms. Extradural spinal meningiomas, however, represent only 2–3.5% of cases. These tumors tend to be more aggressive, often invading neural structures, particularly the brachial plexus. This results in faster progression, higher recurrence rates, and challenges in achieving complete resection. Case Description: A 52-year-old male presented with right-hand muscle hypotrophy and motor deficits. Magnetic resonance imaging (MRI) revealed a large extradural mass from C7 to D3, compressing neural structures. Surgical resection was performed, and histopathology confirmed a World Health Organization Grade I meningothelial meningioma. Postoperative follow-up showed significant neurological improvement, and control MRI confirmed optimal decompression of the spinal cord and neural structures. Conclusion: Extradural spinal meningiomas are rare and challenging to treat due to their invasive nature. Surgical resection with decompression, combined with adjuvant therapies like radiotherapy, is crucial for managing residual disease and improving long-term outcomes. A multidisciplinary approach is essential to optimize patient recovery and quality of life.