Chordoid glioma of the third ventricle: A systematic review and single-center experience

Abstract

BackgroundChordoid gliomas (CG) are neoplasms within the anterior part of the third ventricle. ObjectiveTo analyze all reported cases of CG with regard to imaging features, neurosurgical approaches, VP-shunt dependency, immunohistochemistry and follow-up. Furthermore, we present three cases. MethodsClinical symptoms, MRI features and immunohistochemistry were analyzed in 70 cases. Univariate analyses of extent of resection, surgical approaches, recurrence rates and postoperative hydrocephalus were performed. Three cases are reported with focus on clinical presentation, surgical results, immunohistochemistry and follow-up. ResultsHeadache (51.4%), visual deterioration (41.4%) and memory deficits (21.4%) are the main symptoms. MRI shows a homogenously enhancing solid mass in 84.8% with cysts in 20% of all reported cases. 20% of the patients treated by a subtotal resection (STR) and 0% by a gross total resection (GTR) had a recurrence (p = 0.034). VP-Shunt dependency was higher in the STR group (19.2%) compared with GTR group (5%; p = 0.067). Rate of GTR of the subfrontal trans-lamina terminalis route (83.3%) was superior to the interhemispheric transcallosal approach (23.1%; p = 0.041). GFAP (100%), Vimentin (100%) and CD 34 (69.6%) are the strongest immunohistochemical markers. Two female and one male patient were admitted to our department. However, in one case recurrence ouccured at 18 months after STR. ConclusionDespite the benign histopathology, CGs have high recurrence rates. Morphologically, CGs are solid homogenously enhancing tumors. GTR should be achieved, preferably by the trans-lamina terminalis route. Anatomy and immunohistochemistry seem to show tanycytic origin of this entity.