Summary
Objective: To describe a novel histological subtype of skull base and cranial cervical meningioma
operated upon through an uncommon atlanto basioccipital approach
Study design: Clinical case report
Animal: A seven-year-old neutered female Boxer
Methods: The dog was presented due to lethargic behavior, signs of head and neck pain, and
ongoing tetraparesis. Neurological examination and magnetic resonance imaging led
to diagnosis of a ventral spinal canal mass causing severe cord and brainstem compression
and which required surgical management.
Results: The mass was approached through a ventral craniectomy extending cranially on the
basioccipital bone. Extemporaneous cytological examination of the mass led to confirmation
of neoplastic nature of the abnormal tissue. Cytoreduction of the mass was performed
using multiple cycles of curettage, lavage and suction. Histopathological examination
of the tumour was consistent with a papillary variant of meningioma. Adjuvant therapy
was declined by the owners. The dog improved considerably in the postoperative period,
however three months after surgery signs of recurrence led to euthanasia.
Conclusions: Basioccipital craniectomy allowed a limited but sufficient approach for cytoreduction
of a compressive meningioma of the brainstem and cranial cervical spinal cord. Papillary
meningiomas are locally infiltrative and postoperative recurrence is common.
Clinical relevance: Basioccipital approach combined with cranial atlanto corpectomy can be performed
to relieve compression of the caudal brainstem and cranial cervical cord.
Keywords
Dog - neurosurgery - meningioma - basioccipital - approach
