Kajiwara Y, Kodama Y, Hotta T, Kohno H, Taniguchi E, Yamasaki F, Katayama S, Yamane M
Department of Neurosurgery, Kure National Hospital, Japan.
No Shinkei Geka. 1999 Oct;27(10):947-51.
Chordoid meningioma is a very rare variant, especially in adults. We report an adult case of chordoid meningioma. A 52-year-old man was admitted to our hospital due to right hemiparesis. MRI revealed a left temporal convexity mass that showed two structures; the cerebral layer was shown as an isointensity area on T1WI and T2WI, and the dural layer seemed relatively hypointense on T1WI and hyperintense on T2WI. The tumor was well enhanced with gadolinium, especially on the dural side. A left external carotid arteriogram showed tumor stains with feeding vessels from the left middle meningeal artery. The tumor was totally removed via fronto-temporal craniotomy. Histological examination of the surgical specimen revealed two different structural components, meningothelial meningioma on the cerebral side, and chordoid meningioma on the dural side, consisting of clustering spindled cells and partly vacuolated ones in the mucoid stroma. In immunohistochemical examination, tumor cells showed positive staining for vimentin and epithelial membrane antigen (EMA), and negative for cytokeratin. From the above findings, this case was diagnosed as chordoid meningioma in an adult, a very rare variant of meningioma.
脊索样脑膜瘤是一种非常罕见的变异型,尤其在成年人中。我们报告一例成人脊索样脑膜瘤病例。一名52岁男性因右侧偏瘫入住我院。MRI显示左侧颞叶凸面有一肿块,呈现两种结构;脑层在T1WI和T2WI上表现为等信号区,硬脑膜层在T1WI上相对低信号,在T2WI上高信号。肿瘤用钆剂增强良好,尤其是在硬脑膜侧。左侧颈外动脉造影显示肿瘤染色,供血血管来自左侧脑膜中动脉。通过额颞开颅术将肿瘤完全切除。手术标本的组织学检查显示两种不同的结构成分,脑侧为脑膜上皮型脑膜瘤,硬脑膜侧为脊索样脑膜瘤,由聚集的梭形细胞和部分在黏液样基质中呈空泡状的细胞组成。免疫组化检查中,肿瘤细胞波形蛋白和上皮膜抗原(EMA)染色阳性,细胞角蛋白染色阴性。根据上述发现,该病例被诊断为成人脊索样脑膜瘤,这是一种非常罕见的脑膜瘤变异型。