PAPILLARY (MALIGNANT) MENINGIOMA OF THE FORAMEN MAGNUM PRESENTING AS A POSTERIOR NECK MASS

Meningiomas and neurofibromas are the most common extramedullary tumor s in the region of the foramen magnum. The clinical symptoms are varia ble, including headache, occipitocervical pain, and hoarseness. Neurol ogical symptoms are present only in 40% of cases. The age group ranges from 4 to 56 years. A number of patients are misdiagnosed as multiple sclerosis, syringomyelia, and cervical disc disease. The overall inci dence of these tumors vary from 1.6 to 2.4%. The majority of meningiom as are histologically benign. Papillary (malignant) meningiomas are ev en rarer in this location. The present report is that of a 46-year-old man who developed a painless mass in the nape of his neck, without an y neurological symptoms. Following initial biopsy at another hospital, a definitive resection was undertaken at Loyola University Medical Ce nter. The diagnosis of a malignant meningioma was made after extensive immunohistochemical and electron microscopic studies. The patient dev eloped a positive cervical lymph node 1 year later, which was excised and showed identical histopathologic features