C2 neurinoma with intracranial extension: A case report

We report a rare case presenting with a C2 neurinoma, which extended beyond the foramen magnum, producing a huge mass at the clivus. A 10-year-old boy with medical history of glycogenosis type VIII and attention-deficit hyperactivity disorder had been suffering from progressing foramen magnum syndrome for 36 months. MRI demonstrated a huge tumor, 70 mm in a diameter, which distributed in both the intra- and extra-spinal canal at the C2 level and extended into the intracranial space beyond the foramen magnum. The tumor was totally removed via the trascondylar fossa approach with C1 hemilaminectomy. Operative findings indicated that the tumor arising from extradural C2 nerve intruded into the intradural space, and extended beyond the foramen magnum. Foramen magnum tumors sometimes remain unrecognized until severe neurological deficits develop because of bizarre symptomatology. Surgical strategies with less invasiveness based on early diagnosis lead to successful recovery of neurological function.