Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 10, 2015
Chordoid Meningioma of the Third Ventricle
- Background:
- Chordoid meningioma is a rare meningioma variant (~0.5%) with histologic features resembling that of a chordoma. It is a WHO grade 2 tumor with a higher tendency to recur than typical meningiomas.
- Clinical Presentation:
- Headache or seizures
- Reports have linked chordoid meningiomas with microcytic anemia and Castleman disease. (This patient did not have either condition.)
- Key Diagnostic Features:
- Prior case reports have suggested that most imaging findings are similar to other meningiomas, ie, iso- to hypointense on T1 with avid enhancement post-contrast. Some case reports have shown that these lesions may be mildly to markedly hyperintense on T2-weighted images.
- Differential Diagnosis:
- The main pathologic differential is chordoid glioma.
- Radiographic differential includes typical meningioma and astrocytoma.
- Treatment:
- Surgical resection, possibly with neoadjuvant radiation therapy
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