Giant Lateral Thoracic Meningocele Incidentally Detected During Breast Cancer Screening in a Patient with Type 1 Neurofibromatosis

Abstract

Lateral thoracic meningocele is a saccular protrusion of the meninges from the enlarged intervertebral foramen. It is a very rare pathology usually accompanied by Type 1 Neurofibromatosis (NF-1). Radiological examinations of the patient with known invasive ductal breast carcinoma and NF-1 were performed for the differential diagnosis of the non FDG-avid hypodense lesion extending to the spinal canal detected at the 18-Fluorodeoxyglucose Positron Emission Tomography (18-FDG PET CT). Computed Tomography and Magnetic Resonance Imaging findings of the case are presented with the previous literature. It is important to distinguish the paraspinal masses from metastasis or other benign and malignant masses in order to prevent unnecessary follow-ups and interventional procedures.

Keywords

• Invazive ductal carcinoma, Breast
• Mediastinal neoplasms
• Meningocele
• Neurofibromatosis 1

Tip 1 Nörofibromatozis Hastasında Meme Kanseri Taraması Esnasında Tesadüfen Saptanan Dev Lateral Torasik Meningosel

Abstract

Lateral torasik meningosel, genişlemiş intervertebral foramenden meninkslerin sakküler protrüzyonudur. Genellikle Tip 1 Nörofibromatozis (NF-1) ile birlikte olan çok nadir karşılaşılan bir patolojidir. Bilinen invaziv duktal meme karsinomu ve NF-1 tanısı olan hastanın metastaz taraması için çekilen 18-Florodeoksiglukoz Pozitron Emisyon Tomografisinde (18-FDG PET BT) spinal kanala uzanan FDG tutulumu saptanmayan hipodens lezyonun ayırıcı tanısı yapılmak üzere radyolojik incelemeleri yapılmıştır. Olgunun Bilgisayarlı Tomografi ve Manyetik Rezonans Görüntüleme bulguları literatür eşliğinde sunulmuştur. Paraspinal kitlenin metastaz veya diğer benign ve malign kitlelerden ayırt edilmesi gereksiz izlem ve girişimsel işlemlerin önlenmesi bakımından önemlidir.

Keywords

• İnvaziv duktal karsinomu, Meme
• Medistinal neoplaziler
• Meningosel
• Nörofibromatozis 1

References

1. 1. Tonsgard JH. Clinical manifestations and management of neurofibromatosis type 1. Semin Pediatr Neurol 2006; 13: 2-7.
2. 2. Wallace MR, Marchuk DA, Andersen LB, et al. Type 1 neurofibromatosis gene: identification of a large transcript disrupted in three NF1 patients. Science 1990; 249: 181-186.
3. 3. Rubin S, Stratemeier EH: Intrathoracic meningocele; a case report. Radiology 1952; 58: 552-555.
4. 4. Ferner RE. Neurofibromatosis 1 and neurofibromatosis 2: a twenty first century perspective. Lancet Neurol 2007; 6: 340-351.
5. 5. Sorensen SA, Mulvihill JJ, Nielsen A. Long-term follow-up of von Recklinghausen neurofibromatosis: survival and malignant neoplasms. N Engl J Med 1986; 314: 1010-1015.
6. 6. Oner AY, Uzun M, Tokgoz N, Tali ET. Isolated true anterior thoracic meningocele. AJNR Am J Neuroradiol 2004; 25: 1828-1830.
7. 7. de Andrade GC, Braga OP, Hisatugo MK, de Paiva Neto MA, Succi E, Braga FM. Giant intrathoracic meningoceles associated with cutaneous neurofibromatosis type I: case report. Arq Neuropsiquiatr 2003; 61: 677-681.
8. 8. McGregor C, Katz S, Harpham M. Management of a parturient with an anterior sacral meningocele. International Journal of Obstetric Anesthesia 2013; 22: 64–67.

9. 9. Ryttman A. Lateral intrathoracic meningocele with spontaneous rupture into the pleural cavity diagnosed with RIHSA myelography. Neuroradiology 1973; 5: 165-168.
10. 10. Wilson HE, Ernst RW. Massive hemothorax caused by an intrathoracic meningocele: a case report. J Thorac Surg 1959; 37: 387-392.
11. 11. Zamponi C, Cervoni L, Caruso R. Large intrathoracic meningocele in a patient with neurofibromatosis: technical report. Neurosurg Rev 1996; 19: 275-277.
12. 12. Roca R, Alvarez EC, Eloinaz C, Etoledo J. Persistent pleural effusion and post-traumatic subarachnoidalpleural fistula. Eur J Cardiothorac Surg 1992; 6: 165.
13. 13. Chee CP. Posterolateral extradural approach for total excision of lateral thoracic meningocele: technical report. Neurosurgery 1987; 21: 749-751.
14. 14. Martelli M, Treggiari S, Capece G, Sorrone A. Intrathoracic meningocele: A case report and review of the literature (Italian). Minerva Chir 1992; 47: 1845- 1857.
15. 15. Dinç C, İplikçioğlu AC, Nanruz Y, Çakabay M, Tufan A, Koşdere S. Nörofibromatozis tip 1 ile birlikte görülen intratorasik meningosel: olgu sunumu. Türk Nörosirürji Dergisi 2006; 16: 114-7.
16. 16. Ilias I, Shulkin B, Pacak K. New functional imaging modalities for chromaffin tumors, neuroblastomas and ganglioneuromas. Trends Endocrinol Metab 2005; 16: 66-72.
17. 17. Kocatürk C. Mediastinal nörojenik tümörler. Toraks Cerrahisi Bülteni 2011; 2: 106-16.