Recurrent calcified spinal meningioma detected by plain radiograph.

STUDY DESIGN: A case report of a patient presenting with a rare calcified spinal meningioma that recurred and became symptomatic 33 years after initial surgery was performed. OBJECTIVES: To demonstrate a calcified recurrent spinal meningioma visible on a plain radiograph. The present case is discussed in conjunction with a review of previous cases of calcified spinal meningioma. SUMMARY OF BACKGROUND DATA: Meningioma is a common spinal tumor that has a favorable prognosis if resected completely. Microscopic calcification is frequently found in spinal meningiomas because of psammoma bodies. However, calcified meningiomas in the spinal canal that can be detected on a plain radiograph are uncommon. To the authors' knowledge, there have been no previous reports of recurrent spinal meningioma with calcification visible on a plain radiograph. METHODS: A patient experienced difficulty in walking and was diagnosed as having a spinal meningioma. Laminectomies and a total tumor excision were performed. Histologically, the tumor was diagnosed as a psammomatous meningioma. The tumor recurred and became symptomatic 33 years after the initial operation. The tumor was detected on a plain radiograph, appearing as a calcified tumor at the same thoracic level as the site of the initial operation. The recurrent tumor was completely removed, and a histologic examination showed huge psammoma bodies with calcification, but without ossification. RESULTS: Preoperative paraplegia improved after the surgery, and she was able to walk with a crutch. The patient was discharged from the hospital. CONCLUSIONS: The recurrent psammomatous meningioma contained clusters of calcified psammoma bodies, resulting in a hard tumor that was visible on a plain radiograph.

Paratibial cyst associated with wear debris after total knee arthroplasty.

We present a case in which a synovial cyst arose from the proximal tibia and expanded in the calf of a patient after total knee arthroplasty. A cystogram showed a direct communication between the joint cavity and the cyst, apparently associated with a screw that penetrated the tibial cortex. Histologic examination of the cyst showed an inflammatory reaction, including macrophages, foreign body giant cells, and metal and polyethylene particles. To our knowledge, this is the first case report illustrating a paraosseous cyst that developed after total knee arthroplasty. Wear debris from the total knee prosthesis may have been responsible for this unusual cyst.