Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of chordoma presenting as recurrent bacterial meningitis with cerebrospinal fluid leakage

Shoichiro Ando, M.D.1), Hiroyuki Usuda, M.D., Ph.D.2), Yoshitaka Umeda, M.D.1), Maiko Umeda, M.D.1), Mutsuo Oyake, M.D., Ph.D.1) and Nobuya Fujita, M.D., Ph.D.1)

1)Department of Neurology, Nagaoka Red Cross Hospital
2)Department of Pathology, Nagaoka Red Cross Hospital

A 52-year-old man was admitted to our hospital because of two episodes of bacterial meningitis within a 6-month period. CSF examination showed neutrophilic pleocytosis with marked elevation of protein and hypoglycorrhachia, but the inflammatory reaction was mild and blood and CSF cultures were negative. At the time of the second admission, intermittent watery nasal discharge caused by CSF rhinorrhea was evident. CT and MR imaging revealed a tiny clival bone defect, and transnasal endoscopic repair was performed successfully. The pathological diagnosis was chordoma based on immunohistochemical staining for brachyury. Although chordoma presenting as recurrent bacterial meningitis occurs extremely rare, asking patients detailed questions about the CSF rhinorrhea must be essential for disclosing unclear infection sources.
Full Text of this Article in Japanese PDF (1300K)

(CLINICA NEUROL, 59: 264|267, 2019)
key words: cerebrospinal fluid leaks, recurrent bacterial meningitis, chordoma, MR cisternography

(Received: 11-Jan-19)