1
|
Ren L, Hua L, Deng J, Cheng H, Wang D, Chen J, Xie Q, Wakimoto H, Gong Y. Favorable Long-Term Outcomes of Chordoid Meningioma Compared With the Other WHO Grade 2 Meningioma Subtypes. Neurosurgery 2023; 92:745-755. [PMID: 36512828 PMCID: PMC9988284 DOI: 10.1227/neu.0000000000002272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND WHO grade 2 meningiomas, including atypical, chordoid, and clear cell subtypes, form a heterogenous group of meningiomas with varying aggressiveness and clinical behavior. OBJECTIVE To demonstrate the differences of clinical-histopathological characteristics and long-term outcomes among these 3 subtypes. METHODS A total of 609 consecutive patients diagnosed with WHO grade 2 meningiomas (543 atypical meningiomas [AMs], 36 chordoid meningiomas [CMs], and 30 clear cell meningiomas [CCMs]) from 2010 to 2018 were enrolled in this study. We compared the clinical-histopathological characteristics and long-term outcomes in these 3 subtypes and assessed survival differences among the subtypes. Targeted panel sequencing of meningioma-relevant genes was performed in the cases of CM. RESULTS The patients with CCM were significantly younger than those with AM ( P < .001) and CM ( P = .016). CMs were more likely to receive gross total resection than AMs and CCMs ( P = .033). The Ki-67 index was lower ( P < .001) while the progesterone receptors-positive rate was higher ( P = .034) in CM than in AM and CCM. Importantly, survival analysis demonstrated that CM had better progression-free survival ( P = .022) and overall survival ( P = .0056) than non-CM tumors. However, the PFS of CM was still worse than WHO grade 1 meningiomas ( P < .001). Alterations in NF2 (20.6%) and KMT2C (26.5%) were associated with poorer PFS in CM ( P = .013 for NF2 ; P = .021 for KMT2C ). CONCLUSION Patients with CM had better long-term postoperative outcomes than the other WHO grade 2 subtypes. A lower Ki-67 index, higher PR status, higher extent of resection, and lower frequency of NF2 alteration might contribute to favorable clinical outcomes of CM.
Collapse
Affiliation(s)
- Leihao Ren
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Lingyang Hua
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Jiaojiao Deng
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Haixia Cheng
- Department of Pathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Daijun Wang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Jiawei Chen
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Qing Xie
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
| | - Hiroaki Wakimoto
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ye Gong
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, Shanghai, China
- Department of Critical Care Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| |
Collapse
|
2
|
Jie D, Liu Z, He W, Wang S, Teng H, Xu J. Clinical features, radiological findings, and prognostic factors for primary intracranial chordoid meningioma. Front Neurol 2022; 13:1002088. [PMID: 36438949 PMCID: PMC9684187 DOI: 10.3389/fneur.2022.1002088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/10/2022] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES Chordoid meningioma (CM) is an infrequent histologic subtype of meningiomas. Owing to its low occurrence, this subtype has been rarely described. Our subject was to explore the clinical features, radiological characteristics, and prognostic factors of primary intracranial chordoid meningioma. METHODS We reviewed the medical records and collected follow-up information of 34 cases who had been surgically treated and histologically diagnosed with CM at the Department of Neurosurgery, West-China Hospital of Sichuan University, from January 2009 to December 2021. RESULTS Among all 7,950 meningioma cases, the proportion of primary intracranial CM was 0.43% (34/7,950). The median diagnosis age was 47 (ranging from 12 to 74) and the gender ratio (male to female) was 2.1:1. For radiological features, heterogeneous enhancement, skull base, and ventricular localization, cystic degeneration and dural tail sign were common in CM cases. In treatment, gross total resection (GTR) was achieved in 22/34 cases (64.7%) and subtotal resection (STR) was achieved in 12/34 cases (35.3%). Further, 11/34 patients (32.4%) had received postoperative adjuvant radiotherapy (RT). The follow-up duration ranged from 4 to 157 months after operation. The progression rate was 20.7% (6/29) and the median of PFS was 38 months. By survival analysis, accepting adjuvant radiotherapy and achieving GTR were correlated with longer progression-free survival for prognosis. CONCLUSION CM is a rare subtype of meningiomas. In our series, it mainly involved adults and did not show a predilection for women compared with meningiomas in general. For a better prognosis, gross total resection and postoperative adjuvant radiotherapy are recommended. Nevertheless, due to the restriction of the series sample, patients lost for follow-up and inherent biases of a retrospective study, more cases and a shorter follow-up duration are needed for better management of chordoid meningioma.
Collapse
Affiliation(s)
- Danyang Jie
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zhiyong Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Wenbo He
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Shumin Wang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Haibo Teng
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Wang ZL, Mou JH, Sun D, Liu P. Case Report: Upper Thoracic Purely Extradural Spinal Meningioma With Nerve Root Attachment: A Case Report and Literature Review. Front Surg 2022; 9:918094. [PMID: 35784918 PMCID: PMC9243507 DOI: 10.3389/fsurg.2022.918094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction We describe a case of purely extradural spinal meningioma (EDSMs) with nerve root attachment and present the clinical profiles, radiological findings, operative management, and follow-up data, along with a literature review. This case study is purely extradural spinal meningioma attached to the nerve root, and the available literature review discusses the diagnosis and treatment. Purely epidural spinal meningiomas are extremely rare, and only a few clinical reports are published on this disease. Although epidural meningioma is a benign tumor, the recurrence rate is higher when compared with ordinary meningioma. Case study A 39-year-old male complained of chest and back pain with ring-shaped radiations to the precordial area and numbness in both the lower extremities. After a long walk, he felt disharmony in both his lower limbs. Magnetic resonance imaging showed a mass located on the left posterolateral side of the T1–T3 spinal cord and exhibited a dumbbell-type growth outward at the level of the T2–T3 intervertebral foramen. On the left side of the thoracic, a hemilaminectomy procedure was performed. The tumor was found in the ventral side of the left nerve root of T1 and was surrounded by the left nerve root of T2. To obliterate the tumor, the T2 nerve root was severed. The patient was advised to come for the follow-up on the 3rd, 6th, and 12th months postoperatively, and there were no complaints or signs of recurrence. Conclusion Purely extradural spinal meningioma with nerve root attachment is rare and has no clinical symptoms and image findings. To completely resect the lesion and avoid recurrence, the affected nerve root, epidural fat tissue, and nerve root sheath should be extensively resected and burned, coagulating the adjacent ventral posterior longitudinal ligament.
Collapse
|
4
|
Daoud EV, Zhu K, Mickey B, Mohamed H, Wen M, Delorenzo M, Tran I, Serrano J, Hatanpaa KJ, Raisanen JM, Snuderl M, Cai C. Epigenetic and genomic profiling of chordoid meningioma: implications for clinical management. Acta Neuropathol Commun 2022; 10:56. [PMID: 35440040 PMCID: PMC9020042 DOI: 10.1186/s40478-022-01362-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Chordoid meningioma is a morphological variant of meningioma designated as WHO grade 2. However, the recurrence rates varied widely in different case series, and to date, a unifying molecular genetic signature has not been identified. Among 1897 meningiomas resected at our institution, we identified 12 primary chordoid meningiomas from 12 patients. Histologically, all 12 cases had predominant (> 50%) chordoid morphology. Ten were otherwise grade 1, and two were also atypical. We performed DNA global methylation profile, copy number variation analysis, and targeted next-generation sequencing on 11 chordoid meningiomas, and compared to those of 51 non-chordoid, mostly high grade meningiomas. The chordoid meningiomas demonstrated a unique methylation profile in tSNE, UMAP, and hierarchical heatmap clustering analyses of the most differentially methylated CpGs. The most common copy number variation in chordoid meningioma was loss of 1p (7/11, 64%). Three chordoid meningiomas had 2p loss, which was significantly higher than the non-chordoid control cohort (27% vs 7.2%, p = 0.035). 22q loss was only seen in the two cases with additional atypical histological features. Chordoid meningiomas were enriched in mutations in chromatin remodeling genes EP400 (8/11,73%) KMT2C (4/11, 36%) and KMT2D (4/11, 36%), and showed low or absent NF2, TERT, SMO, and AKT1 mutations. Prognosis wise, only one case recurred. This case had atypical histology and high-grade molecular features including truncating NF2 mutation, 1p, 8p, 10, 14, 22q loss, and homozygous deletion of CDKN2A/B. Progression free survival of chordoid, otherwise grade 1 meningioma was comparable to non-chordoid WHO grade 1 meningioma (p = 0.75), and significantly better than chordoid WHO grade 2 meningioma (p = 0.019). Conclusion: the chordoid histology alone may not justify a universal WHO grade 2 designation. Screening for additional atypical histological or molecular genetic features is recommended.
Collapse
|
5
|
Prokopienko M, Wierzba-Bobrowicz T, Grajkowska W, Stępień T, Sobstyl M. Chordoid Meningioma. Case Report and Review of the Literature. Niger J Clin Pract 2022; 25:1-4. [PMID: 35046187 DOI: 10.4103/njcp.njcp_667_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Chordoid meningioma is an uncommon histopathological type of meningioma, frequently associated with Castleman's syndrome. Histologically, chordoid meningiomas are similar to chordomas. Because of their high proliferative index, they present aggressive biological behavior and high risk of postoperative recurrence. We report a case of chordoid meningioma in an adult patient without Castleman's syndrome manifestation. As its chordoid feature is related with a rapid recurrence after incomplete removal, meticulous histopathological examination is crucial for the adequate postoperative treatment plan.
Collapse
Affiliation(s)
- M Prokopienko
- Department of Neurosurgery, Institute of Psychiatry and Neurology, Sobieskiego, Warsaw, Poland
| | - T Wierzba-Bobrowicz
- Department of Neuropathology, Institute of Psychiatry and Neurology, Sobieskiego, Warsaw, Poland
| | - W Grajkowska
- Department of Neuropathology, Institute of Psychiatry and Neurology, Sobieskiego, Warsaw, Poland
| | - T Stępień
- Department of Neuropathology, Institute of Psychiatry and Neurology, Sobieskiego, Warsaw, Poland
| | - M Sobstyl
- Department of Neuropathology, Institute of Psychiatry and Neurology, Sobieskiego, Warsaw, Poland
| |
Collapse
|
6
|
Yagi C, Yamamuro S, Ozawa Y, Yoshimura S, Sumi K, Yoshino A. A Case of Tuberculum Sellae Chordoid Meningioma Treated via Extended Endoscopic Endonasal Trans-sphenoidal Surgery. NMC Case Rep J 2020; 7:53-56. [PMID: 32322451 PMCID: PMC7162809 DOI: 10.2176/nmccrj.cr.2019-0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022] Open
Abstract
A 68-year-old female was admitted to our hospital with right-sided hemianopsia. Magnetic resonance imaging (MRI) demonstrated a well-enhanced tuberculum sellae region tumor. The patient underwent surgical tumor resection via an extended endoscopic endonasal trans-sphenoidal approach and the tumor was totally removed. The mass was extremely soft and there was no clear attachment between it and the dura mater. Furthermore, the histopathological findings obtained for the tumor during intra-operative rapid diagnosis were divergent from typical meningioma. We therefore diagnosed the tumor intra-operatively as a pituitary adenoma. However, the post-operative pathological diagnosis for the tumor was chordoid meningioma (CM). CM is a rare subtype of meningioma, and most of such tumors arise in the convexity. In the preoperative MRI in the present case, meningioma was suspected; however, since we did not consider CM for differential diagnosis, we failed to reach an accurate diagnosis during the operation. Tuberculum sellae CM is very rare, and only a few cases have been reported previously. The surgical strategy will differ greatly depending on whether the tumor is a meningioma or a pituitary adenoma, especially when treatment involves the dura mater. The pre and/or intra-operative diagnosis is thus very important for developing an accurate treatment strategy. We report here the details of our rare case and describe the intra-operative features of tuberculum sellae CM.
Collapse
Affiliation(s)
- Chihiro Yagi
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Shun Yamamuro
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshinari Ozawa
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Sodai Yoshimura
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Koichiro Sumi
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Atsuo Yoshino
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
7
|
Combined 68Ga-NOTA-PRGD2 and 18F-FDG PET/CT Can Discriminate Uncommon Meningioma Mimicking High-Grade Glioma. Clin Nucl Med 2018; 43:648-654. [PMID: 30052597 DOI: 10.1097/rlu.0000000000002233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Uncommon pathological subtypes of meningioma may present with severe peritumoral brain edema and mimic high-grade glioma (HGG). In a prospective cohort study of Ga-NOTA-PRGD2 PET/CT to evaluate glioma, we occasionally observed that a combination of Ga-NOTA-PRGD2 and F-FDG was able to differentiate these 2 lesion types. METHODS From 2013 to 2016, 21 patients suspected of HGG by MRI were recruited for evaluation using Ga-NOTA-PRGD2 PET/CT. Brain F-FDG PET/CT was performed within 3 days for comparison, and the tumor was surgically removed. The PET results were compared with integrin αvβ3 expression and microvascular density quantification of tumor samples. RESULTS Of the 21 recruited patients, 5 patients were finally pathologically diagnosed as uncommon meningioma with severe peritumoral brain edema, including chordoid meningioma (n = 1), angiomatous meningioma (n = 1), and mixed angiomatous and microcystic meningioma (n = 3). Sixteen were diagnosed as HGG. All the meningioma lesions (n = 5) exhibited intense and homogeneous Ga-NOTA-PRGD2 uptake with higher SUVmax on Ga-NOTA-PRGD2 PET (1.64-7.86; mean ± SD, 4.23 ± 2.48) than the HGG lesions (0.81-2.99; mean ± SD, 1.57 ± 0.33; P = 0.0047). Moreover, the uptake ratios of Ga-NOTA-PRGD2 over F-FDG, normalized as lg100 * SUVmax (RGD / FDG), in the uncommon meningiomas were significantly higher than those in HGG (1.87 ± 1.36 vs 1.04 ± 0.87, P = 0.0001). A cutoff value of 1.58 was able to discriminate between these lesion types. There were positive correlations among the expression level of integrin αvβ3, microvascular density, and the tumor-to-background ratio derived from Ga-NOTA-PRGD2 PET (P < 0.05). CONCLUSIONS This study reveals a specific imaging pattern of uncommon meningioma mimicking HGG, in which Ga-NOTA-PRGD2 PET provided added value to F-FDG PET.
Collapse
|
8
|
Guadagno E, Presta I, Maisano D, Donato A, Pirrone CK, Cardillo G, Corrado SD, Mignogna C, Mancuso T, Donato G, Del Basso De Caro M, Malara N. Role of Macrophages in Brain Tumor Growth and Progression. Int J Mol Sci 2018; 19:ijms19041005. [PMID: 29584702 PMCID: PMC5979398 DOI: 10.3390/ijms19041005] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 03/10/2018] [Accepted: 03/23/2018] [Indexed: 12/16/2022] Open
Abstract
The role of macrophages in the growth and the progression of tumors has been extensively studied in recent years. A large body of data demonstrates that macrophage polarization plays an essential role in the growth and progression of brain tumors, such as gliomas, meningiomas, and medulloblastomas. The brain neoplasm cells have the ability to influence the polarization state of the tumor associated macrophages. In turn, innate immunity cells have a decisive role through regulation of the acquired immune response, but also through humoral cross-talking with cancer cells in the tumor microenvironment. Neoangiogenesis, which is an essential element in glial tumor progression, is even regulated by the tumor associated macrophages, whose activity is linked to other factors, such as hypoxia. In addition, macrophages play a decisive role in establishing the entry into the bloodstream of cancer cells. As is well known, the latter phenomenon is also present in brain tumors, even if they only rarely metastasize. Looking ahead in the future, we can imagine that characterizing the relationships between tumor and tumor associated macrophage, as well as the study of circulating tumor cells, could give us useful tools in prognostic evaluation and therapy. More generally, the study of innate immunity in brain tumors can boost the development of new forms of immunotherapy.
Collapse
Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences-Pathology Section, University of Naples "Federico II"-via Pansini 5, 80131 Naples, Italy.
| | - Ivan Presta
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Domenico Maisano
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Annalidia Donato
- Department of Medical and Surgical Sciences-University of Catanzaro "Magna Graecia"-viale Europa, 88100 Catanzaro, Italy.
| | - Caterina Krizia Pirrone
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Gabriella Cardillo
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Simona Domenica Corrado
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Chiara Mignogna
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Teresa Mancuso
- Department of Medical and Surgical Sciences-University of Catanzaro "Magna Graecia"-viale Europa, 88100 Catanzaro, Italy.
| | - Giuseppe Donato
- Department of Health Sciences, University of Catanzaro "Magna Græcia"-viale Europa, 88100 Catanzaro, Italy.
| | - Marialaura Del Basso De Caro
- Department of Advanced Biomedical Sciences-Pathology Section, University of Naples "Federico II"-via Pansini 5, 80131 Naples, Italy.
| | - Natalia Malara
- Department of Clinical and Experimental Medicine-University of Catanzaro "Magna Graecia"-viale Europa, 88100 Catanzaro, Italy.
| |
Collapse
|
9
|
Chordoid meningioma: a clinico-pathological study of an uncommon variant of meningioma. J Neurooncol 2018; 137:575-582. [DOI: 10.1007/s11060-018-2748-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
|
10
|
Tulloch I, Georges H, Phadke R, Hardwidge C. A thoracic extradural chordoid meningioma: a unique case report and literature review. Br J Neurosurg 2018; 34:112-114. [PMID: 29355032 DOI: 10.1080/02688697.2018.1426721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We describe the unique case of a patient being diagnosed with a thoracic extradural chordoid meningioma following her presentation with mild lower limb pyramidal weakness and a T8 sensory level. This is the first report of an extradural chordoid meningioma being identified in the thoracic spine. The tumour was successfully resected through a posterior thoracic laminectomy approach. Post-operatively, her neurological deficit resolved and to date she has not experienced a radiological recurrence. In this report, we review the literature and discuss this unusual tumour's characteristics and prognostic significance.
Collapse
Affiliation(s)
- Isabel Tulloch
- Neurosurgery, Atkinson Morley Unit, St George's Hospital, London, UK
| | - Husam Georges
- Neurosurgery, Brighton and Sussex University Hospital, Brighton, UK
| | - Rahul Phadke
- Neuropathology, University College London Hospital, London, UK
| | - Carl Hardwidge
- Neurosurgery, Brighton and Sussex University Hospital, Brighton, UK
| |
Collapse
|
11
|
Barresi V, Caffo M, Tuccari G. Classification of human meningiomas: lights, shadows, and future perspectives. J Neurosci Res 2016; 94:1604-1612. [DOI: 10.1002/jnr.23801] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Valeria Barresi
- Department of Human Pathology “G. Barresi,”; University of Messina; Messina Italy
| | - Maria Caffo
- Department of Neuroscience; University of Messina; Messina Italy
| | - Giovanni Tuccari
- Department of Human Pathology “G. Barresi,”; University of Messina; Messina Italy
| |
Collapse
|
12
|
Darlix A, Zouaoui S, Rigau V, Bessaoud F, Figarella-Branger D, Mathieu-Daudé H, Trétarre B, Bauchet F, Duffau H, Taillandier L, Bauchet L. Epidemiology for primary brain tumors: a nationwide population-based study. J Neurooncol 2016; 131:525-546. [PMID: 27853959 DOI: 10.1007/s11060-016-2318-3] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/06/2016] [Indexed: 01/20/2023]
Abstract
Primary central nervous system tumors (PCNST) are rare tumors responsible for high mortality and morbidity. Their epidemiology is poorly known, and clinical data are scarcely analyzed at a national level. In this study, we aimed at providing descriptive epidemiological data and incidence rates for all histological subtypes of PCNST according to the WHO classification. We conducted a nationwide population-based study of all newly diagnosed and histologically confirmed PCNST in France, between 2006 and 2011. A total of 57,816 patients were included: male 46.4%, median age at diagnosis 56 years old (range 0-99). For all newly diagnosed PCNST with histological confirmation the crude incidence rate was 15.5/105 per 100,000 person-years. To enable international comparisons, standardized rates were calculated: 14.1/105 (population of reference: USA), 14.5/105 (population of reference: Europe), and 12.0/105 (population of reference: world). 23.4% of samples were cryopreserved. Resection was performed in 79.1% of cases. Results are detailed (incidence rate, sex ratio, median age at diagnosis, number of cryopreserved samples, and type of surgery) for each of the 143 histological subtypes of PCNST, including all rare tumors. For example, incidence rates (population of reference: USA) were 0.018/105 for anaplastic gangliogliomas, 0.054/105 for malignant meningiomas, and 0.036/105 for hemangiopericytomas. Our study is the first to describe incidence rates and epidemiological data for all histological subtypes of PCNST, including rare tumors, at a national level. Its methodology ensures the exhaustiveness of the data collection for histologically-proven cases. Histological population-based studies have many perspectives in the field of clinical epidemiology and research.
Collapse
Affiliation(s)
- Amélie Darlix
- Department of Medical Oncology, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France.
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France.
| | - Sonia Zouaoui
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Valérie Rigau
- Department of Pathology, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Faiza Bessaoud
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Dominique Figarella-Branger
- Department of Neuropathology and INSERM U911, Timone Hospital, Université de la Méditerranée, 40 rue Ste Baume, 13010, Marseille, France
| | - Hélène Mathieu-Daudé
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Brigitte Trétarre
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Fabienne Bauchet
- Department of Epidemiology, French brain tumor database, GNOLR, Registre des Tumeurs de l'Hérault, Institut Régional du Cancer de Montpellier (ICM)-Val d'Aurelle, 208 rue des Apothicaires, 34298, Montpellier, France
| | - Hugues Duffau
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| | - Luc Taillandier
- Neuro-oncology Unit, University Hospital, 29 avenue du Maréchal de Lattre de Tassigny, Nancy, France
| | - Luc Bauchet
- INSERM U1051, 80 avenue Augustin Fliche, 34091, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, 80 avenue Augustin Fliche, 34090, Montpellier, France
| |
Collapse
|
13
|
Gonzalez-Quarante LH, Ruiz-Juretschke F, Iza-Vallejo B, Scola-Pliego E, Poletti D, Sola Vendrell E. Expanded Endoscopic Transclival Approach for Resection of a Chordoid Meningioma without Dural Attachment (MWODA) Located in the Prepontine Cistern. World Neurosurg 2016; 91:675.e5-675.e10. [DOI: 10.1016/j.wneu.2016.04.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/17/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
|
14
|
Yang Y, Li D, Cao XY, Hao SY, Wang L, Wu Z, Zhang JT. Clinical Features, Treatment, and Prognostic Factors of Chordoid Meningioma: Radiological and Pathological Features in 60 Cases of Chordoid Meningioma. World Neurosurg 2016; 93:198-207. [PMID: 27060511 DOI: 10.1016/j.wneu.2016.03.097] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 03/28/2016] [Accepted: 03/29/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE As one subtype of meningiomas, chordoid meningiomas (CMs) are rarely described. In this study, the authors aimed to analyze the incidence, clinical features, treatment, and prognostic factors of CMs. METHODS Among 9873 cases of meningioma surgically treated between 2003 and 2013 at Beijing Tiantan Hospital, cases of CM were chosen for analysis and were reviewed retrospectively. To ascertain which factors were related with progression-free survival (PFS), statistical analysis was performed. RESULTS Sixty cases of pathologically confirmed and surgically treated CMs were identified. They accounted for 0.61 % of the entire series of meningioma. Simpson Grade I, II, III, and IV resection was performed in 26, 19, 9, and 6 patients, respectively. Fifty-four patients were followed up for 25-141 months after operation. Of these patients, 19 received postoperative adjuvant radiotherapy. Seventeen patients experienced tumor progression, and median PFS was 54 months. The 3- and 5-year PFS rates were 89.7% and 57.1%, respectively. Two patients died of tumor recurrence and 1 died of unrelated reason. Univariate analysis demonstrated tumor shape and extent of resection were significantly associated with prognosis. Multivariate analysis revealed only extent of resection was an independent prognosis factor for PFS. CONCLUSIONS CM is a rare subtype of World Health Organization grade II meningioma. It more frequently involved the adult patients and was without sex predilection. The confirmed diagnosis relied on pathological validation. Total resection whenever possible is recommended to prolong PFS of patients. The value of adjuvant radiotherapy for CM need to be further studied.
Collapse
Affiliation(s)
- Yang Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Da Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Xiao-Yu Cao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Shu-Yu Hao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Liang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Zhen Wu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China
| | - Jun-Ting Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing; China National Clinical Research Center for Neurological Diseases, Beijing; Center of Brain Tumor, Beijing Institute for Brain Disorders, Beijing; Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China.
| |
Collapse
|
15
|
Predictors of recurrence in the management of chordoid meningioma. J Neurooncol 2015; 126:107-116. [PMID: 26409888 DOI: 10.1007/s11060-015-1940-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/12/2015] [Indexed: 12/25/2022]
Abstract
Management of chordoid meningiomas (CMs) is complicated by high rates of recurrence, particularly following subtotal resection. Optimal management is not established given the paucity of published experience. To identify prognostic factors for recurrence following resection, the authors conducted the largest systematic review of CMs to date. A comprehensive search on MEDLINE (OVID and Pubmed), Scopus, Embase, and Web of Science utilizing the search terms "chordoid" AND "meningioma" was performed to identify all reports of pathologically confirmed intracranial CMs. A total of 221 patients were included, comprising 120 females and 101 males. Mean age, MIB-1/Ki67, and tumor size was 45.5 years, 4.3% (range 0.1-26.6%), and 4.1 cm (range 0.8-10 cm), respectively. 5-, and 10- year progression free survival was 67.5 and 54.4%, respectively. Gross total resection (GTR) and subtotal resection was achieved in 172 and 48 patients, respectively. Adjuvant radiotherapy (RT) was given to 30 patients. Multivariate analysis found GTR was strongly correlated with decreased recurrence rates (HR 0.04, p = <0.0001), while higher MIB-1 labeling index (≥5 vs <5%) was associated with increased recurrence (HR 7.08; p = 0.016). Adjuvant RT, age, gender, and tumor location were not associated with recurrence. GTR resection is the strongest predictor of tumor control, and should be the goal to minimize local progression. Additionally, higher MIB-1 labeling was associated with increased rates of tumor recurrence. Tumors that are subtotally resected or demonstrate higher MIB-1 are at greater recurrence and warrant consideration for RT and close long term follow up.
Collapse
|
16
|
Invasive urothelial carcinoma with chordoid features may be an ominous sign predicting sarcomatoid change: a case report of a bladder carcinoma. Med Mol Morphol 2015; 49:182-7. [DOI: 10.1007/s00795-015-0098-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
|