Objectives Evaluation of the presentation, demographics, pathology and outcomes associated with surgical management of spinal meningiomas and review of an association with a history of preceding breast carcinoma.

Design A retrospective single-centre case series of surgically managed meningiomas over a 4 year period.

Subjects 184 cases of surgically managed intradural lesions from 2014 to 2018.

Results 48 patients were identified as having a spinal meningioma [26% of all spinal tumours]. 42 [88%] were female with a cumulative mean age of 69 years [SD ±10]. Most lesions were located in the thoracic spine [n=41]. The cohort had a Charlson comorbidity index of 3. Weakness [median MRC grade 3], neuropathic pain [mean NPS of 26/100] and problems with gait [median mJOA score of 2] were the commonest presenting symptoms. Post-operatively improvements in MRC, NPS, mJOA and SF36 scores were observed. 16% [n=7] of cases had a preceding history of oestrogen-receptor positive breast carcinoma, with a mean interval time between diagnoses of 8.1 years [SD ±5.1]. Risk analysis using baseline data from national cancer registries demonstrates that the likelihood of both diagnoses to be 4.9%, this is considerably lower than the observed 16% (p=0.01).

Conclusions Analysis of our cohort has demonstrated an association between a preceding diagnosis of oestrogen-receptor positive breast carcinoma and spinal meningiomas that cannot be explained by chance alone.