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ASM may also mimic ovarian cysts, and the risk of cerebrospinal fluid (CSF) leakage is high if spontaneous rupture of the cyst occurs. In this study, the authors presented a rare case of ASM with iatrogenic CSF leakage in a 34-year-old woman with suspected Marfan syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The patient initially presented with a giant ASM that was first misdiagnosed as an ovarian cyst. Previously, it had been partially resected, which was followed by iatrogenic CSF leakage. Symptoms of intracranial hypotension, including postural headache and dizziness, developed within 1 month. Brain magnetic resonance imaging (MRI) showed pituitary enlargement, bilateral subdural effusion, and tonsillar herniation. Preoperative computed tomography myelography provided three-dimensional (3D) examination of the deformed sacrum and CSF leakage site. Transabdominal approaches led to primary repair, and repair of the meningocele was achieved by intraoperative fluorescein fluorescence and 3D printed model\u2013guided polymethyl methacrylate bone cement reconstruction. No CSF leakage or recurrent ASM was found at the 1.5-year follow-up visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Intraoperative intrathecal fluorescence and 3D-printed models are useful for ASM repair. Preoperative MRI is helpful for differentiating ASM from other causes of a huge pelvic mass, including ovarian cyst.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case20159","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T15:50:40Z","timestamp":1621266640000},"source":"Crossref","is-referenced-by-count":5,"title":["Anterior sacral meningocele repair assisted by intraoperative intrathecal fluorescence and 3D printing model: illustrative case"],"prefix":"10.3171","volume":"1","author":[{"given":"Yu-Chaing","family":"Yeh","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Jui","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan City, Taiwan"},{"name":"The Graduate Institute of Biomedical Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hua","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology and"},{"name":"Department of Neuroradiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pao-Shiu","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Guishan Township, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Tsai","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Chang-Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Craniofac Surg","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1097\/SCS.0b013e31821c0f34","article-title":"Is polymethylmethacrylate reliable and practical in full-thickness cranial defect reconstructions?","volume":"22","author":"Akan M","year":"2011","unstructured":"Akan M, Karaca M, Eker G,  Is polymethylmethacrylate reliable and practical in full-thickness cranial defect reconstructions? 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