Skip to main content

Advertisement

Log in

Chordoid meningioma: a report of ten cases

  • Clinical Study - Patient Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Chordoid meningioma is a rare variant of meningioma with histological features resembling those of chordoma. This tumor has a great risk of recurrence and aggressive growth (WHO grade II). This study was done to document the clinical and pathological features of ten patients with chordoid meningioma who submitted to surgery at the National Institute of Neurology and Neurosurgery in Mexico City. Clinical, histological and immunohistochemical features were examined. The age range was from 30 to 67 years old (mean, 34.2 years). Seven patients were female and three male. The duration of symptoms varied from 3.5 months to 5 years (mean, 14.1 months). No systemic symptoms were noted. The tumor was localized in eight cases in the supratentorial compartments. Histologically, the tumors were characterized by strands and cords of meningothelial cells arranged in a mucinous stroma. Two of the ten tumors showed metaplasic changes, and seven showed brain invasion. Tumor cells demonstrated CK7, EMA and focal S-100 protein and Ep-CAM. Cytokeratin AE1/AE3, GFAP and synaptophysin were negative. The MIB-1 proliferative index was from 6 to 9% (mean 7.8). PCNA Li was 6 to 20% (mean, 14), and microvascular density was 6–16 (mean, 14.5). The mean rate of the MIB-1 labeling index in recurrences was 7.1% versus 6.33% for no tumor recurrence. Chordoid meningioma, World Health Organization grade II, is an uncommon variant of meningioma with a propensity for aggressive behavior and increased likelihood of recurrence. Chordoid meningiomas are predominantly tumors of young adults with a predilection for the supratentorial location. Intraventricular location and absence of systemic manifestations, despite the presence of abundant B-lymphocytes, mast cells and low MIB-1 LI, are some of the interesting findings in the present series that need further study. Hence, a larger number of cases with adequate follow-up data need to be studied further to establish the clinical relevance of this variant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kepes JJ, Chen WY, Connors MH, Vogel FS (1988) “Chordoid” meningeal tumors in young individuals with peritumoral lymphoplasmacellular infiltrate causing systemic manifestations of the Castleman syndrome. A report of seven cases. Cancer 62:391–406

    Article  CAS  PubMed  Google Scholar 

  2. Epari S, Sharma MC, Sarkar C, Garg A, Gupta A, Mehta VS (2006) Chordoid meningioma, an uncommon variant of meningioma: a clinicopathologic study of 12 cases. J Neurooncol 78:263–269

    Article  CAS  PubMed  Google Scholar 

  3. Louis DN, Scheithauer BW, Budka H et al (2000) Meningiomas. In: Kleihues P, Cavenee WK (eds) World Health Organization classification of tumours. Pathology and genetics. Tumours of the nervous system. IARC, Lyon, pp 175–184

  4. Kozler P, Benes V, Netuka D, Kramár F, Hrabal P, Charvát F (2008) Chordoid meningioma: presentation of two case reports, review of the literature, and plea for data standardisation. J Neurooncol 88:115–120

    Article  CAS  PubMed  Google Scholar 

  5. Fukushima S, Terasaki M, Shigemori M (2008) Chordoid meningioma arising in the pineal region: a case report. Brain Tumor Pathol 25:91–95

    Article  PubMed  Google Scholar 

  6. Donaro G, Ferraro G, Signorelli F, Iofrida G, Lavano A, Amorosi A, Maltese L, Perrotta I, Tripepi S, Pardatscher K, Signorelli CD (2006) Chordoid meningioma: case report and literature review. Ultrastruct Pathol 30:309–314

    Article  Google Scholar 

  7. Couce ME, Aker FV, Scheithauer BW (2000) Chordoid meningioma: a clinicopathologic study of 42 cases. Am Surg Pathol 24:899–905

    Article  CAS  Google Scholar 

  8. Park SC, Oh DE, Suh YL, Kim YD (2007) Orbital chordoid meningioma: a rare subtype of meningioma. Ophthalmol Plast Reconstr Surg 23:246–248

    Article  Google Scholar 

  9. Scott A, Sharkawi E, Micallef C, Johns P, Grant L (2008) Chordoid meningioma presenting as painful orbital apex syndrome in pregnancy. Int Ophthalmol 28:355–357

    Article  PubMed  Google Scholar 

  10. Hartmann C, Sieberns J, Gehlhaar C, Simon M, Paulus W, von Deimling A (2006) NF2 mutations in secretory and other rare variants of meningiomas. Brain Pathol 16:15–19

    Article  CAS  PubMed  Google Scholar 

  11. Vidal S, Scheithauer BW, Kovacs K, Lloyd RV (2005) Angiogenesis and the growth potential of craniopharyngiomas. Endocr Pathol 16:219–228

    Article  PubMed  Google Scholar 

  12. Arima T, Natsume A, Hatano H, Nakahara N, Fujita M, Ishii D, Wakabayashi T, Doyu M, Nagasaka T, Yoshida J (2005) Intraventricular chordoid meningioma presenting with Castleman disease due to overproduction of interleukin-6. Case report. J Neurosurg 102:733–737

    Article  PubMed  Google Scholar 

  13. Mitsuhashi T, Ono S, Inohara T, Otomo T, Aoki A, Ueki Y (2006) Chordoid meningioma. Case report. Neurol Med Chir (Tokyo) 46:37–40

    Article  Google Scholar 

  14. Ko KW, Nam DH, Kong DS, Lee JI, Park K, Kim JH (2007) Relationship between malignant subtypes of meningioma and clinical outcome. J Clin Neurosci 14:747–753

    Article  PubMed  Google Scholar 

  15. Mullassery D, O’Brien DF, Williams D, Crooks D, Mallucci C, Pizer B, Thorp N, McDowell H (2006) Malignant disseminated chordoid meningioma in a 12-year-old child: a role for early cranial and spinal radiation treatment after subtotal resection. Childs Nerv Syst 22:1344–1350

    Article  PubMed  Google Scholar 

  16. Hasegawa S, Yoshioka S, Urabe S, Kuratsu J (2006) Rapidly enlarging chordoid meningioma with abundant mucin production. Neuropathology 26:438–441

    Article  PubMed  Google Scholar 

  17. Takei H, Bhattacharjee MB, Adesina AM (2006) Chordoid glioma of the third ventricle: report of a case with cytologic features and utility during intraoperative consultation. Acta Cytol 50:691–696

    PubMed  Google Scholar 

  18. Lui PC, Chau TK, Wong SS, Lau PP, Tse GM, Thomas TM, Ng HK (2007) Cytology of chordoid meningioma: a series of five cases with emphasis on differential diagnoses. J Clin Pathol 60:1024–1028

    Article  PubMed  Google Scholar 

  19. Inagawa H, Ishizawa K, Shimada S, Shimada T, Nishikawa R, Matsutani M, Hirose T (2004) Cytologic features of chordoid meningioma. A case report. Acta Cytol 48:397–401

    PubMed  Google Scholar 

  20. Salinero E, Beltran L, Costa JR (2004) Intraoperative cytologic diagnosis of chordoid meningioma. A case report. Acta Cytol 48:259–263

    PubMed  Google Scholar 

  21. Matyja E, Grajkowska W, Lazarczyk M, Marchel A, Czernicki T (2006) Chordoid meningiomas of a different histopathological pattern: a report of two cases. Folia Neuropathol 44:34–41

    PubMed  Google Scholar 

  22. Cummings TJ, Bridge JA, Fukushima T (2004) Extraskeletal myxoid chondrosarcoma of the jugular foramen. Clin Neuropathol 23:232–237

    CAS  PubMed  Google Scholar 

  23. Takei H, Kosarac O, Powell SZ (2009) Cytomorphologic features of myxopapillary ependymoma: a review of 13 cases. Acta Cytol 53:297–302

    PubMed  Google Scholar 

  24. Tena-Suck ML, Salinas-Lara C, Gómez C, Bojórquez DR (2007) Frontotemporal clear cell meningioma. Report of 3 cases. Ann Diagn Pathol 11:182–189

    Article  PubMed  Google Scholar 

  25. Cho HY, Lee M, Takei H, Dancer J, Ro JY, Zhai QJ (2009) Immunohistochemical comparison of chordoma with chondrosarcoma, myxopapillary ependymoma, and chordoid meningioma. Appl Immunohistochem Mol Morphol 17:131–138

    Article  PubMed  Google Scholar 

  26. Sangoi AR, Dulai MS, Beck AH, Brat DJ, Vogel H (2009) Distinguishing chordoid meningiomas from their histologic mimics: an immunohistochemical evaluation. Am J Surg Pathol 33:669–681

    Article  PubMed  Google Scholar 

  27. Brunner EC, Romeike BF, Jung M, Comtesse N, Meese E (2006) Altered expression of beta-catenin/E-cadherin in meningiomas. Histopathology 49:178–187

    Article  CAS  PubMed  Google Scholar 

  28. Ng WH, Hy JW, Tan WL, Liew D, Lim T, Ang BT, Ng I (2009) Aquaporin-4 expression is increased in edematous meningiomas. J Clin Neurosci 16:441–443

    Article  CAS  PubMed  Google Scholar 

  29. Pistolesi S, Boldrini L, Gisfredi S, de Ieso K, Camacci T, Caniglia M, Lupi G, Leocata P, Basolo F, Pingitore R, Parenti G, Fontanni G (2004) Angiogenesis in intracranial meningiomas: immunohistochemical and molecular study. Neuropathol Appl Neurobiol 30:118–125

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martha Lilia Tena-Suck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tena-Suck, M.L., Collado-Ortìz, M.A., Salinas-Lara, C. et al. Chordoid meningioma: a report of ten cases. J Neurooncol 99, 41–48 (2010). https://doi.org/10.1007/s11060-009-0097-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-009-0097-9

Keywords

Navigation