Journal List > Investig Magn Reson Imaging > v.22(4) > 1119749

Kim, Ha, Pak, and Kim: A Case of Thoracic Extradural Chordoid Meningioma: Focusing on Radiologic Features

Abstract

Chordoid meningioma, an uncommon subtype of meningioma, occurs rarely in the spine. In this case report, the authors present a case of spinal chordoid meningioma in a young female patient, and include a detailed description of imaging findings and a literature review.

References

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Fig. 1.
Axial (a) and sagittal (b) CT scans show a well-defined osteolytic lesion without sclerotic margin, involving the T3 vertebral body, right pedicle and lamina.
imri-22-260f1.tif
Fig. 2.
Sagittal fat suppressed T2-weighted image (a), sagittal T1-weighted image (b), sagittal gadolinium-enhanced T1-weighted image (c), sagittal diffusion-weighted image (d), sagittal apparent diffusion coefficient map (e), axial T2-weighted image (f), and axial gadolinium-enhanced T1-weighted image (g). There is an irregularly shaped mass with high signal intensity on T2-weighted images (a, f) and intermediate to low signal intensity on T1-weighted image (b). The mass is located in the extradural space of the T2–3 level, and invades the posterior components of the T3 vertebra. Due to the mass effect, the spinal cord is displaced to the left side. On gadolinium-enhanced T1-weighted image (c, g), the mass shows heterogeneous, but avid enhancement with fuzzy margins. The mass shows slight hyperintensity on diffusion-weighted image (d), and apparent diffusion coefficient map (e).
imri-22-260f2.tif
Fig. 3.
Histopathologic findings. (a) Chords or trabeculae of eosinophilic epithelioid tumor cells in mucoid matrix (Hematoxylin & Eosin [H&E] stain, × 100). (b) Typical meningothelial meningioma-like focus (dotted circle, H&E stain, × 150). (c) Immunohistochemical staining for vimentin highlights the ribbon-like architecture (× 100). (d) Positivity for EMA is typically patchy in meningioma (× 100).
imri-22-260f3.tif
Fig. 4.
On postoperative MRI, ill-defined hyperintense areas are noted in the T3 vertebra on axial T2-weighted image (a), and enhancing lesion in the same area on axial gadolinium-enhanced T1-weighted image (b), suggesting residual tumor.
imri-22-260f4.tif
Table1.
Reported Cases of Spinal Chordoid Meningioma
 Authors (Ref. No.) No. Sex Age Level Location
Sadashiva N, et al., 2018 (1) 1 M 25 C3–5 IDEM
  2 F 36 Foramen magnum to C3 NA
  3 M 27 C1–2 IDEM
Tulloch I, et al., 2018 (2) 4 F 45 T5–7 ED
Yang Y, et al., 2016 (3) 5 NA NA Cervical NA
  6 NA NA Cervical NA
  7 NA NA Thoracic NA
  8 NA NA Thoracic NA
  9 NA NA Lumbar NA
Wu L, et al., 2015 (4) 10 F 12 C2–3 IDEM + ED
Ibrahim A, et al., 2005 (5) 11 M 26 C2–3 IDEM
Couce ME, et al., 2000 (6) 12 F 20 C2 NA
Present case 13 F 26 T2–3 ED

M = male; F = female; IDEM = intradural extramedullary; ED = extradural; NA = not available

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