Clinical Features and Treatment Outcome of Chordoid Meningiomas in a Single Institute

Abstract

ObjectiveMeningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma.MethodsIn total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3-170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04).ResultsSimpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6-71.3) by the log-rank test (p<0.05).ConclusionChordoid meningiomas are difficult to manage and have a high rate of recurrence. Complete resection of the tumor is a key determinant of better outcomes. Adjuvant radiation therapy is recommended, eparticulary when Simpson grade I resection was not achieved.

Predictors of recurrence in the management of chordoid meningioma

“…[9] Recently, Jee et al reported a mean MIB in 11.56% in 16 patients, ranging from 1-26.6%, without correlation to clinical outcomes. [12] Our data reflect the high variability reported in literature, with a mean MIB-LI of 4.4 and a wide range of 0.1-26.6%.…”

“…Higher MIB-LI has been noted to correlate with recurrent meningiomas [28-30], and has also been correlated with increasing WHO grade, with up to 1.35% for benign, up to 9.3% for atypical and up to 19.5% for anaplastic meningiomas. [12, 29, 31, 32] Despite this established trend, MIB-LI for CMs in the literature have been controversial for 2 reasons: reported ranges of MIB-LI are highly variable within studies, and a lack of correlation with outcomes. Couce et al reported a mean MIB-LI of 5.2% with a range of 0.4-11.4%.…”

A Case of Tuberculum Sellae Chordoid Meningioma Treated via Extended Endoscopic Endonasal Trans-sphenoidal Surgery

“…To date, only 10 cases of tuberculum sellae CM have been reported in the English literature. [3][4][5][6][7] We describe here a very rare case of tuberculum sellae CM, which was surgically treated via an endonasal approach using a neuro-endoscope.…”

“…1,2) To date, only a few cases of CM presenting in the tuberculum sellae region have been reported. [3][4][5][6][7]…”

Chordoid Meningioma: Literature Review

“…The differential diagnosis includes chordomas, myxoid chondrosarcoma and chordoid glioma. 1 In the present study, we report a case of a female patient with a diagnosis of a recent onset of headache and visual cloudiness. Meningiomas represent almost 30% of primary intracranial neoplasms.…”