Chordoid meningioma

Case contributed by RMH Neuropathology

Presentation

Vague headaches.

Patient Data

Age: 45 years
Gender: Female
MRI

MRI brain

Pre and post IV contrast multiplanar imaging of the brain has been performed demonstrating a right posterior frontal convexity extraxial mass. It has high T2 signal but is otherwise typical for a meningioma. No adjacent bony or parenchymal changes. Study other wise normal.

Pathology

Histology

MICROSCOPIC DESCRIPTION:  The sections show a moderately cellular meningioma with infiltration into the attached dura. The tumour forms scattered whorls. The background contains abundant mucoid material, in which embedded cords of tumour cells are seen, imparting a chordoid-like appearance. The chordoid pattern occupies more than 50% of the total area. Microcystic change is also focally seen. The tumour cells have ovoid nuclei with no nuclear pleomorphism. Mitoses are inconspicuous. The tumour cells are progesterone receptor positive. The Ki-67 index is about 2% (not shown).

There is no necrosis. No brain parenchyma is seen. In one specimen tumour invades into, but not through, the cortical bone. There is no malignant change. 

FINAL DIAGNOSIS: 

Chordoid meningioma with bone invasion (WHO Grade II).

Case Discussion

Meningiomas with increased risk of recurrence and/or aggressive behaviour include: 

  • Atypical meningioma (Grade II)
  • Chordoid meningioma (Grade II)
  • Clear cell meningioma (Grade II)
  • Papillary meningioma (Grade III)
  • Rhabdoid meningioma (Grade III)
  • Anaplastic (malignant) meningioma (Grade III)
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Case information

rID: 25273
Case created: 17th Oct 2013
Last edited: 22nd Feb 2016
Inclusion in quiz mode: Included

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