Skip to main content

Advertisement

SpringerLink
Log in

Chordoid meningioma of the foramen magnum in a child: a case report and review of the literature

  • Case Report
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

We report a 3-year-6-month-old boy with chordoid meningioma in the foramen magnum. Chordoid meningioma represents between 0.5 and 1.0% of all meningiomas, and it is frequently located in the supratentorial region. The patient started with an episode of instability, falls, and headache; after which, he developed cuadriparesis, cervical pain, and neck stiffness, which slightly improved after medical treatment, so he was referred to our hospital. Physical examination revealed left hemiparesis and cervical muscle spasm with left torticollis. Magnetic resonance imaging (MRI) demonstrated an intradural–extramedullary well-circumscribed, homogeneous enhancing mass, in the anterior part of the foramen magnum with cervical extension. The operative technique was the extreme-lateral craniocervical retrocondylar approach with total removal and dural coagulation. Histopathological examination demonstrated a chordoid meningioma, with meningotelial basophilic mucoid chordoma-like component in 80% of the tissue. The immunohistochemical stains were positive to epithelial membrane antigen, vimentin, and S-100 protein. At 10 months follow-up, the patient showed improvement in his neurological deficit with physical rehabilitation, and motor response in his extremities are now normal; neck stiffness with cervical spasm disappeared postoperatively. MRI showed no residual tumor. To our knowledge, this is the first report of a chordoid meningioma on the foramen magnum in a child.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

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

    Article  PubMed  CAS  Google Scholar 

  2. De Oliveira E, Rhoton AL, Peace D (1985) Microsurgical anatomy of the region of the foramen magnum. Surg Neurol 24:293–352

    Article  PubMed  Google Scholar 

  3. Deen HG, Scheithauer BW, Ebersold MJ (1982) Clinical and pathological study of meningiomas of the firs two decades of life. J Neurosurg 56:317–322

    PubMed  Google Scholar 

  4. 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  PubMed  CAS  Google Scholar 

  5. George B, Lot G, Boissonnet H (1997) Meningioma of the foramen magnum: a series of 40 cases. Surg Neurol 47:371–379

    Article  PubMed  CAS  Google Scholar 

  6. George B, Lot G, Velut S (1993) Tumors of the foramen magnum. Neurochirurgie 39:1–89

    PubMed  Google Scholar 

  7. Germano IM, Edwards MSB, Davis RL, Schiffer D (1994) Intracranial meningiomas of the first two decades of life. J Neurosurg 80:447–453

    PubMed  CAS  Google Scholar 

  8. Glasier CM, Husain MM, Chadduck W, Boop FA (1993) Meningiomas in children: MR and histopathologic findings. Am J Nueroradiol 14:237–241

    CAS  Google Scholar 

  9. Heros RC (1986) Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg 64:559–562

    PubMed  CAS  Google Scholar 

  10. Howe JR, Taren JA (1973) Foramen magnum tumors. Pitfalls in diagnosis. JAMA 225:1061–1066

    Article  PubMed  CAS  Google Scholar 

  11. 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 

  12. Jääskeläinen J, Haltia M, Laasonen E, Wahlström T, Valtonen S (1985) The growth rate of intracranial meningiomas and its relation to histology: an analysis of 43 patients. Surg Neurol 24:165–172

    Article  PubMed  Google Scholar 

  13. Jääskeläinen J (1986) Seemingly complete removal of histologically benign intracranial meningioma: late recurrence rate and factors predicting recurrence in 657 patients. Surg Neurol 26:461–469

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  15. Kleihues P, Louis DN, Scheithauer BW, Rorke LB, Reifenberger G, Burger PC, Cavenee WK (2002) The WHO classification of tumors of the nervous system. J Neuropathol Exp Neurol 61:215–225

    PubMed  Google Scholar 

  16. Kleihues P, Burger PC, Scheithauer BW (1993) Histological typind of tumours of the central nervous system, 2nd edn. Springer, Berlin

    Google Scholar 

  17. Kleihues P, Burger PC, Scheithauer BW (1993) The new WHO classification of brain tumours. Brain Pathol 3:255–268

    Article  PubMed  CAS  Google Scholar 

  18. Kobata H, Kondo A, Iwasaki K, Kusaka H, Ito H, Sawada S (1998) Chordoid meningioma in a child. Case report. J Neurosurg 88:319–323

    PubMed  CAS  Google Scholar 

  19. Kumar CVR, Satyanarayana S, Mohan BR, Palur RS (2001) Extreme lateral approach to ventral and ventrolaterally situated lesions of the lower brainstem and upper cervical cord. Skull Base 11:265–275

    Article  PubMed  CAS  Google Scholar 

  20. Margalit NS, Lesser JB, Singer M, Sen C (2005) Lateral approach to anterolateral tumors at the foramen magnum: factors deterining surgical procedure. Neurosurgery 56(Suppl 2):324–336

    Article  PubMed  Google Scholar 

  21. Meyer FB, Emersold MJ, Reese DF (1984) Benign tumors of the foramen magnum. J Neurosurg 61:136–142

    PubMed  CAS  Google Scholar 

  22. 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. Child’s Nerv Syst 22:1344–1350

    Article  Google Scholar 

  23. Rhoton AL (1994) Meningiomas of the cerebellopontine angle and foramen magnum. Neurosurg Clin North Am 5:349–376

    Google Scholar 

  24. Rorke LB, Gilles FH, Davis RL, Becker LE (1985) Revision of the World Health Organization Classification of brain tumors for childhood brain tumors. Cancer 56:1869–1886

    Article  PubMed  CAS  Google Scholar 

  25. Rushing EJ, Olsen C, Mena H, Rueda ME, Lee YS, Keating RF, Packer RJ, Santi M (2005) Central nervous system meningiomas in the first two decades of life: a clinicopathological analysis of 87 patients. J Neurosurg (Pediatrics) 103(6 Suppl):489–495

    Google Scholar 

  26. Salas E, Sekhar LN, Ziyal IM, Caputy AJ, Wright DC (1999) Variations of the extreme-lateral craniocervical approach: anatomical study and clinical analysis of 69 patients. J Neurosurg (Spine) 90(2):206–219

    CAS  Google Scholar 

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

    PubMed  Google Scholar 

  28. Sen CN, Sekhar LN (1990) An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum. Neurosurgery 27:197–204

    Article  PubMed  Google Scholar 

  29. Simpson, D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiat 20:22–39

    PubMed  CAS  Google Scholar 

  30. Stein BM, Leeds NE, Taveras JM, Pool JL (1963) Meningiomas of the foramen magnum. J Neurosurg 20:740–751

    Article  PubMed  CAS  Google Scholar 

  31. Taylor AR, Byrnes DP (1974) Foramen magnum and high cervical cord compression. Brain 97:473–480

    Article  PubMed  CAS  Google Scholar 

  32. Vural M, Arslantas A, Ciftci E, Artan S, Atasoy MA (2007) An unusual case of cervical clear-cell meningioma in pediatric age. Child’s Nerv Syst 23:225–229

    Article  Google Scholar 

Download references

Acknowledgments

To Gloria Angélica Díaz Méndez, M.D., for her support in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Pediatric Neurosurgery, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Cuicuilco, Delegación Coyoacán, C.P. 04530, Mexico, DF, Mexico

    Alfonso Marhx-Bracho, Fernando Rueda-Franco, Abraham Ibarra-de la Torre & Oscar García-González

  2. Department of Pathology, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Colonia Cuicuilco, Delegación Coyoacán, C.P. 04530, Mexico, DF, Mexico

    Leticia Bornstein-Quevedo & Beatriz de León-Bogorge

Authors
  1. Alfonso Marhx-Bracho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fernando Rueda-Franco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abraham Ibarra-de la Torre
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oscar García-González
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Leticia Bornstein-Quevedo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Beatriz de León-Bogorge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alfonso Marhx-Bracho.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marhx-Bracho, A., Rueda-Franco, F., Ibarra-de la Torre, A. et al. Chordoid meningioma of the foramen magnum in a child: a case report and review of the literature. Childs Nerv Syst 24, 623–627 (2008). https://doi.org/10.1007/s00381-007-0568-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-007-0568-2

Keywords

Search

Navigation