Clinical features and surgical outcomes of spinal clear cell meningioma: An institutional experience

Clear cell meningiomas are uncommon tumors in the spinal canal. The clinical and radiological features, clinicopathological characteristics, treatment results, and long-term outcomes of this rare entity are still uncertain. The authors review their experience in a surgical series of 10 patients with histologically proven spinal clear cell meningioma treated at a single institution and discuss clinical features, radiological findings, and surgical outcomes. There were 3 male and 7 female patients with a mean age of 25.5 +/- 17.7 years. The mean follow-up period was 68.4 +/- 32.7 months. One tumor was in the cervical spine, 2 were in the thoracic spine, 2 were in the thoracolumbar spine, and 5 were in the lumbar or lumbosacral spine. Gross total resection of the tumor with a well-demarcated dissection plane was achieved in 9 patients, while subtotal resection was achieved in 1 patient, and no patients underwent postoperative radiotherapy. Symptoms present before surgery had improved in 9 patients at the last follow-up. Postoperative follow-up magnetic resonance imaging showed no recurrence/regrowth in the 9 patients with total removal and 1 patient with subtotal removal during the mean follow-up periods of 68.4 months and 56.0 months, respectively. Clear cell meningiomas should be considered in the differential diagnosis of young female patients with spinal tumors involving the lower thoracic, lumbar or sacral region. Although the nature of this disease is aggressive, spinal clear cell meningiomas are amenable to surgery. The risk of long-term lesion recurrence is low if complete removal can be achieved, and followup imaging is still needed. (C) 2019 Elsevier Ltd. All rights reserved.