Investig Magn Reson Imaging.  2015 Jun;19(2):117-121. 10.13104/imri.2015.19.2.117.

Chordoid Glioma Originating in the Intrasellar and Suprasellar Regions: Case Report

• Hwang J
• Lee A
• Chang KH
• Moon AR
• Hwang SC
• Hong HS

• KMID: 2175592
• DOI: http://doi.org/10.13104/imri.2015.19.2.117

Abstract

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.

Keyword

Chordoid glioma; Third ventricle; Radiological feature; Magnetic resonance imaging

MeSH Terms

Brain Neoplasms
Disease Progression
Female
Glioma*
Headache
Humans
Magnetic Resonance Imaging
Middle Aged
Optic Chiasm
Radiosurgery
Third Ventricle

Figure

• 

  Fig. 1 An axial precontrast (a) and a contrast-enhanced (b) computed tomography scan show an oval, well-defined, and hyperdense mass with strong and homogenous enhancement in the sellar and suprasellar regions.

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  Fig. 2 Magnetic resonance images of the tumor. (a) Sagittal T1-weighted image shows low signal intensity of the mass. (b) Coronal T2-weighted image shows iso- to high signal intensity of the mass. Coronal (c) and sagittal (d) contrast-enhanced T1-weighted images of the brain reveal a strong, homogeneously enhancing solid sellar and suprasellar mass, not connected to the third ventricle. The normal pituitary gland and stalk are not discernible. The epicenter of the mass appears to originate in the sella, and not in the lamina terminalis of the anterior third ventricle.

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  Fig. 3 Histological features of the tumor. (a) The tumor shows clusters and cords of epithelioid-to-spindle cells embedded in a myxoid matrix and inflammatory cells (Hematoxylin & Eosin staining, original magnification × 100). (b) The positive immunoreactivity for glial fibrillary acidic protein expression are visualized as brown (original magnification × 200).

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