Chordoid Meningioma: Case Report and Literature Review

Donato, Giuseppe; Ferraro, Giuseppe; Signorelli, Francesco; Iofrida, G; Lavano, Angelo; Amorosi, Andrea; Maltese, Lorenza; Perrotta, Ida; Tripepi, Sandro; Pardatscher, K.; Cd, Signorelli

doi:10.1080/01913120600820591

Cited by 21 publications

(18 citation statements)

References 19 publications

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“…Meta-analysis results of previously reported immunohistochemical findings in chordoid meningioma 6,17,21,22,24,30,35,36,38,40,42,43,45,47– 49,51–54,61,62,70,75,77,80,82,86 (published in English language) are shown in Figure 7. Additional immunohistochemical staining results in chordoid meningioma reported in the literature (which were not included in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…22,46 Although secretory activity may be identified by electron microscopy in chordoid-predominant areas of chordoid meningioma, 22 careful ultrastructural exploration for areas of typical meningioma may be necessary. In addition, a unique unbalanced translocation involving chromosomes 1 and 3 identified in 3 cases of chordoid meningioma not observed in other meningioma subtypes 78 suggests that cytogenetic studies and potentially fluorescence in-situ hybridization methodologies could be of diagnostic utility, although further investigation in this area is needed.…”

Section: Discussionmentioning

confidence: 99%

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Distinguishing Chordoid Meningiomas From Their Histologic Mimics

Sangoi

Dulai²,

Beck

et al. 2009

American Journal of Surgical Pathology

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Chordoid meningioma, World Health Organization grade II, is an uncommon variant of meningioma with a propensity for aggressive behavior and increased likelihood of recurrence. As such, recognition of this entity is important in cases that show similar morphologic overlap with other chondroid/myxoid neoplasms that can arise within or near the central nervous system. A formal comparison of the immunohistochemical features of chordoid meningioma versus tumors with significant histologic overlap has not been previously reported. In this study, immunohistochemical staining was performed with antibodies against D2-40, S100, pankeratin, epithelial membrane antigen (EMA), brachyury, and glial fibrillary acidic protein (GFAP) in 4 cases of chordoid glioma, 6 skeletal myxoid chondrosarcomas, 10 chordoid meningiomas, 16 extraskeletal myxoid chondrosarcoma, 18 chordomas, 22 low-grade chondrosarcomas, and 27 enchondromas. Staining extent and intensity were evaluated semiquantitatively and mean values for each parameter were calculated. Immunostaining with D2-40 showed positivity in 100% of skeletal myxoid chondrosarcomas, 96% of enchondromas, 95% of low-grade chondrosarcomas, 80% of chordoid meningiomas, and 75% of chordoid gliomas. Staining with S100 demonstrated diffuse, strong positivity in all (100%) chordoid gliomas, skeletal myxoid chondrosarcomas, low-grade chondrosarcomas, and enchondromas, 94% of chordomas, and 81% of extraskeletal myxoid chondrosarcomas, with focal, moderate staining in 40% of chordoid meningiomas. Pankeratin highlighted 100% of chordoid gliomas and chordomas, 38% of extraskeletal myxoid chondrosarcomas, and 20% of chordoid meningiomas. EMA staining was positive in 100% of chordoid gliomas, 94% of chordomas, 90% of chordoid meningiomas, and 25% of extraskeletal myxoid chondrosarcomas. Brachyury was positive only in the chordomas (100%), whereas GFAP was positive only in the chordoid gliomas (100%). EMA was the most effective antibody for differentiating chordoid meningioma from skeletal myxoid chondrosarcoma, low-grade chondrosarcoma, and enchondroma, whereas D2-40 was the most effective antibody for differentiating chordoid meningioma from extraskeletal myxoid chondrosarcoma and chordoma. Our findings demonstrate that in conjunction with clinical and radiographic findings, immunohistochemical evaluation with a panel of D2-40, EMA, brachyury, and GFAP is most useful in distinguishing chordoid meningioma from chordoid glioma, skeletal myxoid chondrosarcoma, extraskeletal myxoid chondrosarcoma, chordoma, low-grade chondrosarcoma, and enchondroma. A lack of strong, diffuse S100 reactivity may also be useful in excluding chordoid meningioma. Among the neoplasms evaluated, brachyury and GFAP proved to be both sensitive and specific markers for chordoma and chordoid glioma, respectively. Of note, this study is the first to characterize the D2-40 immunoprofile in extraskeletal myxoid chondrosarcoma, results that could be of utility in differential diagnostic assessment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Distinguishing Chordoid Meningiomas From Their Histologic Mimics

Sangoi

Dulai²,

Beck

et al. 2009

American Journal of Surgical Pathology

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“…5 The absence of systemic inflammatory syndrome in adults with chordoid meningioma along with ultrastructural features prompted some authors to suggest that these tumors may be only a morphological variant of meningioma in adults, whereas in children this may represent a true meningioma subtype. 6 The cause of the systemic inflammatory syndrome in patients with a meningioma also remains unclear. Different pathophysiological mechanisms proposed include the characteristic lymphocytic infiltration 7 and interleukin-6.…”

Section: Discussionmentioning

confidence: 99%

“…The aggressive behavior and tendency for early recurrence is well documented. 6,11 In particular, the proliferation index and extent of resection is generally accepted as one of the most important prognostic factors for WHO Grade II meningeal tumors. Subtotal resection has specifically been stated as a risk factor for recurrence for intraventricular meningiomas.…”

Section: Discussionmentioning

confidence: 99%

Intraventricular chordoid meningioma in a child: fever of unknown origin, clinical course, and response to treatment

Nambiar

Pillai

Parmar

et al. 2012

PED

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The authors present the case of an 11-year-old boy with an intraventricular chordoid meningioma, which is a rare presentation of prolonged fever of unknown origin due to a rare tumor in a rare location. The fever resolved after excision of the lesion. Subsequent imaging revealed recurrence at 1 year. After a repeat excision and fractionated radiotherapy, the patient has remained disease free 5 years after the first surgery. Very few cases of intraventricular chordoid meningioma have been reported to date. The pathological features and clinical course are described. A review of the literature describing management options for this tumor type, recently found to have a higher recurrence rate, is described herein.

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“…The type of meningioma that can show low density on CT are lymphoplasmacyte-rich meningioma, micorcystic meningioma and chordoid meningioma, but they usually show peritumoral oedema 1 4 6 7. The histological diagnosis was meningothelial meningioma as most of the specimen's appearance was meningothelial.…”

Section: Differential Diagnosismentioning

confidence: 99%

Low-grade meningioma showing nearly equal density with spinal fluid on radiographic images

et al. 2013

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A 61-year-old woman had an intracranial tumour that was located on the falx. Meningioma was suspected and the tumour rapidly grew over 1 year. It showed nearly equal density with spinal fluid showing almost no enhancement on radiographic images, like microcystic meningioma. Successful removal of the tumour was achieved. Histopathologically, the tumour was diagnosed as low-grade meningioma. The meningioma had variable sized microcysts and the appearance of solid area was meningothelial meningioma. This is a rare radiographic image for meningothelial meningioma.

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Chordoid Meningioma: Case Report and Literature Review

Cited by 21 publications

References 19 publications

Distinguishing Chordoid Meningiomas From Their Histologic Mimics

Distinguishing Chordoid Meningiomas From Their Histologic Mimics

Intraventricular chordoid meningioma in a child: fever of unknown origin, clinical course, and response to treatment

Low-grade meningioma showing nearly equal density with spinal fluid on radiographic images

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