Dual meningiomas with different pathology at the same spinal level: a rare case report

• Two psammomatous meningiomas occurred at the same spinal level but in distinct locations. • Careful preoperative MRI assessment allowed precise surgical planning. • Gross total resection led to significant symptom relief. • Long-term follow-up is recommended due to the risk of recurrence. Background : Spinal meningiomas are typically solitary and histologically uniform. The coexistence of two distinct histological subtypes at the same spinal level is extremely rare. Case Presentation: We report a 65-year-old female with bilateral lower extremity weakness. MRI revealed two enhancing intradural extramedullary tumors at T12–L1—one right anterolateral and one left posterolateral. Both were completely resected through a single laminectomy. Histopathology confirmed meningothelial and psammomatous meningiomas (WHO Grade I). Conclusion (Clinical Utility) This case highlights the importance of considering multiple lesions with differing histopathologies, even at the same level, in surgical planning. Awareness of this rare coexistence helps achieve total resection in a single session and avoid unnecessary extended exposure.