Abstract
A 64-year-old male patient presented with generalized convulsions. Magnetic resonance imaging revealed a large meningeal tumor with some cysts in the right frontal region. Surgical resections were performed three times, and local radiation therapy was administered twice over a period of 8 years for the treatment of tumor recurrences. The tumor tended to recur in spite of the surgical and radiation therapies. The tumor was diagnosed as a chordoid meningioma, and the second surgical specimen showed increasing nuclear atypia and mitoses in tumor cells. An immunohistochemical study revealed the tumor cells were positive for vimentin, S-100 protein, and cytokeratin AE1/AE3. An electron microscopic study revealed intracytoplasmic vacuolar spaces, loosely connected interdigitating cell processes with intermediate junctions, and extracellular spaces which contained fluffy granular intercellular substances. The tumor cell surfaces displayed pseudopodia which extended into the intercellular spaces and the tumor cells had moderate quantities of cytoplasm containing abundant mitochondria and glycogen granules. According to the ultrastructural features in the past reports of chordoid meningiomas, these meningiomas are suspected to have a mixture of the characteristic ultrastructural features of meningothelial meningiomas and chordoid sarcomas.
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Kepes JJ, Chen WY-K, Connors MH, et al. (1988) “Chordoid” meningeal tumors in young individuals with peritumoral lymphoplasmacelluar infiltrates causing systemic manifestions of the Castleman syndrome. Cancer 62:391–406
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
Zuppan CW, Linwnicz BH, Weeks DA (1994) Meningioma with chordoid features. Ultrastruct Pathol 18:29–32
Kobata H, Kondo A, Iwasaki K (1998) Chordoid meningioma in a child: case report. J Neurosurg 88:319–323
Couce ME, Aker FV, Scheithauer BW (2000) Chordoid meningioma: a clinicopathologic study of 42 cases. Am J Surg Pathol 24:899–905
Yano H, Shinoda J, Hara A, et al. (2000) Chordoid meningioma. Brain Tumor Pathol 17:153–157
Murali R, Ng T (2004) Chordoid meningioma masquerading as chordoma. Pathology 36:198–201
Inagawa H, Ishizawa K, Shimada S, et al. (2004) Cytologic features of chordoid meningioma; a case report. Acta Cytol 48:397–401
Donato G, Ferraro G, Signorelli F, et al. (2006) Chordoid meningioma: case report and literature review. Ultrastruct Pathol 30: 309–314
Fukushima S, Terasaki M, Shigemori M (2008) Chordoid meningioma arising in the pineal region: a case report. Brain Tumor Pathol 25:91–95
Kleihues P, Burger PC, Scheithauer BW (1993) Histological typing of tumours of the central nervous system, second edn. Springer-Verlag, Berlin Heidelberg New York Tokyo, pp 35–36
Arima T, Natsume A, Hatano H, et al. (2005) Intraventricular chordoid meningioma presenting with Castleman disease due to overproduction of interleukin-6; case report. J Neurosurg 102: 733–737
Denaro L, Rocco FD, Gessi M, et al. (2005) Pyogenic cytokine interleukin-6 expression by a chordoid meningioma in an adult with a systemic inflammatory syndrome; case report and review of the literature. J Neurosurg 103:555–558
Song KS, Park SH, Cho BK, et al. (2008) Third ventricular chordoid meningioma in a child. J Neurosurg Pediatr 2:269–272
Takei H, Rivera A, Suzuki H, et al. (2006) Jugular foramen chordoid meningioma. Pathol Int 56:397–401
Marhx-Bracho A, Rueda-Franco F, Ibarra-de LT, et al. (2008) Chordoid meningioma of the foramen magnum in a child: a case report and review of the literature. Childs Nerv Syst 24:623–627
Epari S, Sharma MC, Sarkar C, et al. (2006) Chordoid meningioma, an uncommon variant of meningioma: a clinicopathologic study of 12 cases. J Neurooncol 78:263–269
Hasegawa S, Yoshioka S, Urabe S, et al. (2006) Rapidly enlarging chordoid meningioma with abundant mucin production. Neuropathology 26:438–441
Lee DK, Kim DG, Choe G, et al. (2001) Chordoid meningioma with polyclonal gammopathy: Case report. J Neurosurg 94: 122–126
Soo MYS, Ng T, Gomes L, et al. (2004) Case report; skull base chordoid meningioma: imaging features and pathology. Australas Radiol 48:233–236
Carstens PHB (1995) Chordoid tumor: a light, electron microscopic, and immunohistochemical study. Ultrastruct Pathol 19:291–295
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This case was presented at the 16th annual meeting of the Japan Society of Brain Tumor Pathology in Fukuoka, Japan, on May 28, 1998.
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Kano, T., Nakazato, Y., Tamura, M. et al. Ultrastructural and immunohistochemical study of an adult case of chordoid meningioma. Brain Tumor Pathol 26, 37–42 (2009). https://doi.org/10.1007/s10014-009-0245-0
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DOI: https://doi.org/10.1007/s10014-009-0245-0