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Meningiomas are relatively common primary spinal tumours, being the second most common intraspinal tumours probably after vertebral haemangioma.
It constitutes about 25% of all intraspinal tumours; however, in the presence of extradural spinal lesions, the diagnosis of meningioma is uncommon and often not among the first two considerations. Purely extradural spinal meningioma, especially of the “En plaque” variety, usually simulate malignant disease (metastatic diseases and lymphoma) and may result in inadequate therapy, however, the presence of nerve root attachment is even rarer.
Our case report is that of an entirely cervicothoracic extradural en‑plaque meningioma (WHO grade 1) with a nerve root attachment (right C7) and intrathoracic extension. We highlighted the issues in diagnosis, operative intervention and long-term follow-up.