Giant chordoid meningioma symptomatic immediately after pregnancy: report of a rare case.

BACKGROUND

Chordoid meningioma is a very rare subtype of meningioma with less than 90 cases reported in the literature. Meningiomas related with a pregnancy are also very rare. Herein, we present a pregnancy-associated case of a chordoid meningioma and briefly discuss possible mechanisms.

CASE HISTORY: Approximately 10 hours after a Caesarean section, a 37-year-old woman became stuporous with a Glasgow coma scale score of 9 - 10 and the right pupil became dilated without reaction to light. An emergency computed tomography scan showed a right frontotemporal lesion measuring 8 x 7 x 6 cm which enhanced moderately and homogenously after intravenous contrast injection. The patient's hemoglobin level was slightly lower than normal level but there was no dysgammaglobulinemia or lymphoid hyperplasia. The patient was immediately taken to the operating theater and the tumor was gross totally removed. The postoperative period was uneventful; and histopathological diagnosis was chordoid meningioma.

CONCLUSION

The exact mechanism causing a pregnancy-associated increase in the size of meningiomas and the amount of peritumoral edema has not been clearly elucidated. As for this case of chordoid meningioma associated with pregnancy, we think mucin accumulation in tumor could be involved in an increase in the tumor size while delivery procedures with the common anaesthetic and sedative drugs may also have enhanced the peritumoral edema by causing a relative decrease in the cerebral blood flow.