Chordoid Glioma: Ten Years of a Low-Grade Tumor with High Morbidity

Abstract

We report two new cases of chordoid glioma of the third ventricle and review all previously published cases of this rare tumor with regard to presentation, optimum management, and outcome. Two new cases are reported with the radiological and histopathologic findings. We searched and cross-referenced PubMed and published reports of this tumor to retrieve an additional 51 cases of this tumor, which were then analyzed according to a proforma. Chordoid glioma has consistent radiological features, although some atypical elements including a cystic component are well described. The insidious presentation and morbidity of attempted surgical resection combine to give high overall morbidity. There is a high incidence of postoperative thromboembolic disturbance. Adjuvant radiosurgery has a promising role. The morbidity of this condition is likely to remain high but may be minimized by a less aggressive surgical approach together with surveillance and early use of radiosurgery.

Prognostic factors for recurrence and complications in the surgical management of primary chordoid gliomas: A systematic review of literature

“…[13, 19, 26] Of the remaining cases, extent of infiltration was highly variable, ranging from occasional [27, 41] to prominent infiltration. [4, 10, 42, 43] Distribution of tumor infiltrating lymphocytes was also highly variable, with peripheral [21], scattered [30], and focal appearance. [44] Mitoses were consistently low [7, 10, 24, 33, 45–48] or absent [35] when noted.…”

“…The most common surgical approaches described to resect CG include transcallosal in 7 [12, 29, 37, 43, 44, 50], transcortical in 5 [22, 31, 51, 52], and trans-lamina terminalis in 17 [4, 11, 13, 17, 20, 23, 42, 43, 46, 47, 53–55]. Surgical approach was not specified in 52 patients.…”

“…There were 18 cases of hypothalamic dysfunction, of which 13 were new onset diabetes insipidus and 3 were syndrome of inappropriate antidiuretic hormone (SIADH). Less frequently, panhypopituitarism [15, 43] was noted in 2 and weight gain was noted in another 2 cases. [34, 43] New onset seizures were noted 2 days following STR in a 36 year old male.…”

“…Less frequently, panhypopituitarism [15, 43] was noted in 2 and weight gain was noted in another 2 cases. [34, 43] New onset seizures were noted 2 days following STR in a 36 year old male. [42] Short-term memory deficits were present in 7 (8.8%) patients postoperatively.…”

Chordoid glioma of the third ventricle: report of a rapidly progressive case

“…The post-operative course in this other case was complicated and the patient died 1 week following surgery, precluding the correlation of necrosis with post-operative growth properties [8,15,16].…”