Usefulness of neuroimaging and immunohistochemical study for accurate diagnosis of chordoid glioma of the third ventricle: A case report and review of the literature

Abstract

Background:Chordoid glioma of the third ventricle is a rare neuroepithelial tumor characterized by a unique histomorphology within the third ventricular region, but with radiological and histopathological features mimicking benign lesions such as meningioma. We report a case of chordoid glioma of the third ventricle and suggest a useful indicator for accurate diagnosis.Case Description:A previously healthy 46-year-old woman was admitted to our hospital with mild headache. Neuroimaging revealed a large tumor measuring approximately 18 mm in the suprasellar region, and perifocal edema in the optic tract and internal capsule on magnetic resonance imaging. Laboratory findings revealed no pituitary dysfunction including diabetes insipidus. Gross total resection of the tumor was performed by the interhemispheric translamina terminalis approach. Histological findings revealed nests of regular epithelioid cells with large nuclei and abundant eosinophilic cytoplasm within myxoid stroma. Immunohistochemical studies demonstrated diffuse cytoplasmic expression of glial fibrillary acidic protein (GFAP) and CD34, and strong nuclear staining for thyroid transcription factor 1 (TTF-1). We, therefore, histologically classified the tumor as chordoid glioma of the third ventricle. Headache improved immediately postoperatively, and follow-up neuroimaging after 12 months showed no signs of recurrence.Conclusions:Chordoid glioma of the third ventricle is a very rare tumor that is difficult to diagnose on routine neuroimaging. Accurate diagnosis requires detailed analysis of neuroimaging and immunohistochemical studies using CD34 and TTF-1 staining.

Endoscope-assisted Trans-lamina Terminalis Resection of Chordoid Glioma at the Third Ventricle: A Case Report

“…Commonly, MRI findings of CG demonstrate an enhanced homogenous lesion with Gd in the anterior part of the third ventricle, and perifocal edematous lesions are de-tectable in the bilateral basal ganglia. 3) The imaging findings of our case have closely resembled these features (homogenously Gd-enhanced lesion in the anterior part of the third ventricle and a high-intensity signal in FLAIR) in the bilateral basal ganglia. The high FLAIR lesion was larger on the right side, considering that the right side of the tumor has severely adhered to the third ventricle.…”

Occurrence of Chordoid Glioma With Sodium Ion Metabolism Disorder 5 Years After Meningioma Surgery and Whole-Exome Sequencing: A Case Report and Literature Review

“…MRI showed T1W1 imaging hypo-to isointensity, T2W1 imaging iso-to hyperintensity, and enhancement was homogeneous or heterogeneous (Bongetta et al, 2015 ). In some patients, MRI suggests that vasogenic edema and hydrocephalus are relatively special characteristic features, which have great significance for promoting prospective diagnosis (Shinohara et al, 2018 ). The present case also exhibited these characteristics.…”