Rare case of extracranial chordoid meningioma adjacent to the carotid sheath: illustrative case

Abstract

Background: Chordoid meningioma is a rare World Health Organization (WHO) grade 2 variant of meningioma with histological features resembling those of a chordoma. This tumor type is known for having an aggressive clinical course with a propensity for local recurrence. Most cases occur within the cranium, more specifically around the cerebral convexities. Although extracranial meningiomas of various subtypes have been documented, extracranial meningioma with a chordoid subtype is an extremely rare entity.

Observations: The authors herein report the case of a 51-year-old female who presented with a chief complaint of dysphagia and was found to have a neck mass abutting the carotid sheath. The patient underwent resection and final pathology results revealed a WHO grade 2 chordoid meningioma.

Lessons: This case report demonstrates an atypical case of an extracranial chordoid meningioma adjacent to the carotid sheath. To the authors' knowledge, this is the first reported case of a chordoid meningioma occurring within the soft tissue of the neck.

Keywords: carotid sheath meningioma; chordoid meningioma; extracranial chordoid meningioma; extracranial meningioma; meningioma.

FIG. 1.

Preoperative imaging of the neck mass. Left: Axial T1-weighted MRI with contrast showing a homogeneously enhancing right-sided lesion. Right: Axial CTA showing a right-sided mass displacing the external (thin arrow) and internal (thick arrow) carotid arteries medially.

FIG. 2.

Histopathology of the neck mass. The neoplasm was associated with a prominent lymphoplasmacytic inflammatory infiltrate (A) and was composed of cords of cells with prominent vacuolated cytoplasm (B). It infiltrated the adjacent adipose tissue in the neck (C). Hematoxylin and eosin, original magnification ×100 (A and C), ×400 (B).