Third ventricular chordoid glioma with unusual aggressive behavior

Area of Science:

• Neuro-oncology
• Neurosurgery
• Neuropathology

Background:

• Chordoid glioma is a rare, distinct tumor typically found in the suprasellar region.
• This tumor often presents with symptoms related to mass effect and cerebrospinal fluid pathway obstruction.

Observation:

• A 50-year-old woman presented with a 4-year history of cognitive decline and recent vision loss.
• MRI revealed a large, enhancing suprasellar and third ventricular mass causing hydrocephalus.
• The tumor was subtotally resected via a transcallosal approach.

Findings:

• Histopathological examination confirmed chordoid glioma.
• The patient experienced rapid tumor recurrence and hydrocephalus progression within 3 months post-surgery.
• Ventriculoperitoneal shunting was required due to obstructive hydrocephalus.

Implications:

• Subtotal resection of chordoid glioma may necessitate close neuroimaging follow-up due to high recurrence rates.
• Aggressive tumor behavior and rapid progression underscore the challenges in managing this rare neoplasm.
• Early detection of recurrence through regular monitoring is crucial for potential intervention and improved patient outcomes.