Chordoid glioma

Case contributed by Dr Sven Opitz

Presentation

A severe headache for 5 days, vertical diplopia, and nausea.

Patient Data

Age: 75
Gender: Female
CT

Ovoid hyperdense suprasellar mass with contact to the anterior wall of the third ventricle.

No calcifications are recognized within the mass.

MRI

Ovoid, slightly lobulated, well circumscribed mass with contact to the anterior wall of the third ventricle and the optic chiasm. The mass is isointense to white matter in T1 and T2 weighted sequences and shows vivid uniform enhancement after Gadolinium.

The mass shows no arterial flow in TOF-Angiography and ceMRA (not shown).

No susceptibility-artifacts in SWI are recognised within the mass (not shown).

Case Discussion

Presumptive diagnosis was intraventricular meningioma. Neurosurgical biopsy however confirmed a chordoid glioma of the third ventricle:

Histology

Paraffin sections show a moderate hypercellular tumour with mildly pleomorphic and slightly irregular nuclei. The cells form small noduli/ groups, some are arranged in strands with a myxoid tissue matrix. No mitoses.

  • signifikant expression of GFAP and TTF1
  • fokal expression of EMA
  • no Expression of Keratin, SSTR2A, Mutant IDH1 (R132H) or PR
  • Ki67 labeling index <5%

Diagnosis

Chordoid glioma of the third ventricle (WHO II)

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Case information

rID: 55958
Case created: 2nd Oct 2017
Last edited: 3rd Oct 2017
Inclusion in quiz mode: Excluded

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