Rare Suprasellar Chordoid Meningioma with INI1 Gene Mutation

Abstract

Background: Chordoid Meningioma is a rare brain tumour characterized genetically by loss of genetic material from chromosome 22q at cytogenetic level resulting in mutation of NF2 gene.


Objectives and case report: In the present report, we described a rare case of suprasellar chordoid meningioma, which presented in a 32-year-old-woman. Her only complain was throbbing headache. Neurological examination showed left temporal hemianopia, decreased visual acuity (3/6), and no physical abnormalities related to Castleman syndrome were noted. Cranial magnetic resonance (MR) images demonstrated a 28x15 mm mass in the sellar region, which showed iso-to low intensity that enhanced vividly after gadolinium with upwards displacement of the Optic chiasm.


Total surgical excision of the tumour was performed and subsequent histological examination of the tumour showed typical histology pattern of chordoid meningioma grade II according to the WHO classification system of meningiomas.


Genomic DNA was extracted and mutation analysis for INI1 gene using primer of exon 4, 5, 7, and 9 showed mutation involving exon 9. DNA sequencing showedheterozygosity C­­­­­­­­­­­­­­­­­­-T mutation in exon 9 of INI1 gene leading to change of amino acid serine to phenylalanine at (codon 63). The details of this case are presented with a review of the literature.

References
[1] J. J. Kepes, W. Y. Chen, M. H. Connors, and F. S. Vogel, ““Chordoid” meningeal tumors in young individuals with peritumoral lymphoplasmacellular infiltrates causing systemic manifestations of the castleman syndrome. A report of seven cases,” Cancer, vol. 62, no. 2, pp. 391–406, 1988.

[2] P. Kleihues, D. N. Louis, B. W. Scheithauer et al., “The WHO Classification of Tumors of the Nervous System,” Journal of Neuropathology & Experimental Neurology, vol. 61, no. 3, pp. 215–225, 2002.

[3] H. Yano, A. Hara, K. Takenaka et al., “Differential expression of β-catenin in human glioblastoma multiforme and normal brain tissue,” Neurological Research, vol. 22, no. 7, pp. 650–656, 2000.

[4] M. E. Couce, F. V. Aker, and B. W. Scheithauer, “Chordoid meningioma: A clinicopathologic study of 42 cases,” American Journal of Surgical Pathology, vol. 24, no. 7, pp. 899–905, 2000.

[5] P. C. W. Lui, T. K. F. Chau, S. S. Wong et al., “Cytology of chordoid meningioma: A series of five cases with emphasis on differential diagnoses,” Journal of Clinical Pathology, vol. 60, no. 9, pp. 1024–1028, 2007.

[6] S. Nagao, N. Kawai, T. Ohomoto, and T. Oohashi, “A case of intrasellar and suprasellar meningioma with hypopituitarism,” Neurological Surgery, vol. 18, no. 7, pp. 637–642,1990.

[7] J. A. Armstrong, J. J. Bieker, and B. M. Emerson, “A SWI/SNF-related chromatin remodeling complex, E-RC1, is required for tissue-specific transcriptional regulation by EKLF in vitro,” Cell, vol. 95, no. 1, pp. 93–104, 1998.

[8] J. F. Flanagan and C. L. Peterson, “A role for the yeast SWI/SNF complex in DNA replication,” Nucleic Acids Research, vol. 27, no. 9, pp. 2022–2028, 1999.

[9] J. P. Dumanski, V. P. Collins, M. Nordenskjold, and G. A. Rouleau, “Molecular Genetic Analysis of Chromosome 22 in 81 Cases of Meningioma,” Cancer Research, vol. 50, no. 18, pp. 5863–5867, 1990.

[10] B. R. Seizinger, R. L. Martuza, and J. F. Gusella, “Loss of genes on chromosome 22 in tumorigenesis of human acoustic neuroma,” Nature, vol. 322, no. 6080, pp. 644–647, 1986.

[11] C. D. James, E. Carlbom, J. P. Dumanski et al., “Clonal Genomic Alterations in Glioma Malignancy Stages,” Cancer Research, vol. 48, no. 19, pp. 5546–5551, 1988.

[12] C. D. James, J. He, E. Carlbom et al., “Loss of genetic information in central nervous system tumors common to children and young adults,” Genes, Chromosomes and Cancer, vol. 2, no. 2, pp. 94–102, 1990.

[13] D. Simpson, “The recurrence of intracranial meningiomas after surgical treatment,” Journal of Neurology, Neurosurgery, and Psychiatry, vol. 20, no. 1, pp. 22–39, 1957.

[14] W. Stenzel, G. Röhn, H. Miletic, H. Radner, M. Deckert, and R.-I. Ernestus, “Diagnostic impact of ornithine decarboxylase in meningiomas,” Journal of Neuro-Oncology, vol. 66, no. 1-2, pp. 59–64, 2004.

[15] P. Kleihues and W. K. Cavenee, WHO Classification of Tumours Pathology and Genetics of Tumours of Nervous System, IARC press, Lyon, 2000.

[16] U. Schmitz, W. Mueller, M. Weber, N. Sévenet, O. Delattre, and A. V. Deimling, “INI1 mutations in meningiomas at a potential hotspot in exon 9,” British Journal of Cancer, vol. 84, no. 2, pp. 199–201, 2001.

[17] M. Peyrard, I. Fransson, Y.-G. Xie et al., “Characterization of a new member of the human /-adaptin gene family from chromosome 22q12, a candidate meningioma gene,” Human Molecular Genetics, vol. 3, no. 8, pp. 1393–1399, 1994.

[18] F. C. Stam, H. A. M. van Alphen, and D. M. Boorsma, “Meningioma with conspicuous plasma cell components - A histopathological and immunohistochemical study,” Acta Neuropathologica, vol. 49, no. 3, pp. 241–243, 1980.

[19] H. Kobata, A. Kondo, K. Iwasaki, H. Kusaka, H. Ito, and S. Sawada, “Chordoid meningioma in a child. Case report,” Journal of Neurosurgery, vol. 88, no. 2, pp. 319– 323, 1998.

[20] G. W. Mierau and D. A. Weeks, “Chondroid chordoma,” Ultrastructural Pathology, vol. 11, no. 5-6, pp. 731–737, 1987.

[21] D. J. Brat, The elusive origin of chordoid glioma. Arch Pathol Lab Med, 130, 437-438,2006.

[22] M. E. Couce, F. V. Aker, and B. W. Scheithauer, “Chordoid meningioma: A clinicopathologic study of 42 cases,” American Journal of Surgical Pathology, vol. 24, no. 7, pp. 899–905, 2000.