Hasegawa Shu, Yoshioka Susumu, Urabe Shougo, Kuratsu Jun-ichi
Department of Neurosurgery, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto 860-8556, Japan.
Neuropathology. 2006 Oct;26(5):438-41. doi: 10.1111/j.1440-1789.2006.00708.x.
This 77-year-old woman with a rapidly enlarging chordoid meningioma first noticed a growing, non-pulsatile, nonpainful soft mass in the left temporal region after a head trauma 2 years earlier. Neuroimaging showed a homogeneously enhanced osteolytic mass lesion in the left temporal bone. Surgery revealed an extradural tumor without significant adhesions. Histopathologically it was a meningioma with features reminiscent of chordoma. Most of the tumor cells contained mucin-rich chordoid elements. Immunohistochemically, the lesion was positive for vimentin and epithelial membranous antigen; it was negative for cytokeratin and S-100 protein. Based on these findings a diagnosis of chordoid meningioma was made. We posit that the rapid enlargement of the tumor over a relatively short period was attributable to its high mucin-producing activity.
这位77岁的女性患有迅速增大的脊索样脑膜瘤,2年前头部外伤后首次注意到左侧颞区有一个不断增大、无搏动、无痛的软肿块。神经影像学显示左侧颞骨有一个均匀强化的溶骨性肿块病变。手术发现硬膜外肿瘤,无明显粘连。组织病理学检查显示为脑膜瘤,具有脊索瘤的特征。大多数肿瘤细胞含有富含粘蛋白的脊索样成分。免疫组织化学检查显示,病变波形蛋白和上皮膜抗原呈阳性;细胞角蛋白和S-100蛋白呈阴性。基于这些发现,诊断为脊索样脑膜瘤。我们推测,肿瘤在相对较短的时间内迅速增大是由于其高粘蛋白产生活性。