Bongetta Daniele, Risso Andrea, Morbini Patrizia, Butti Giorgio, Gaetani Paolo
Neurosurgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università degli Studi di Pavia, Piazzale Golgi 19, 27100, Pavia, Italy.
Unit of Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico S. Matteo, Piazzale Golgi 19, 27100, Pavia, Italy.
World J Surg Oncol. 2015 May 28;13:188. doi: 10.1186/s12957-015-0603-9.
Chordoid glioma (CG) is a rare central nervous system neoplasm (WHO grade II) of uncertain origin whose typical localization is in the anterior part of the third ventricle. Its clinical, radiological, and histological features may vary and furthermore mimic other kind of benign lesions usually associated with a better outcome. We report a case of a 43-year-old female who underwent gross total removal of a lesion of the third ventricle causing hydrocephalus. The imaging studies and the intraoperative examination led at first to a hypothesis of meningioma. Early surgical and neurological outcomes were good. The patient underwent multiple complications related to hypothalamic dysfunctions and thrombohemorragic issues and eventually died because of systemic infections. Definitive examination was of chordoid glioma of the third ventricle. Reviewing literature, we evaluated possible pitfalls in radiological and histological diagnosis as well as in surgical and medical treatment of CGs. Despite their benign presentation, a high incidence of multiple possible severe complications is reported. Early alertness and combined treatment strategies could improve overall CGs treatment strategies.
脊索样胶质瘤（CG）是一种起源不明的罕见中枢神经系统肿瘤（世界卫生组织二级），其典型定位在第三脑室前部。其临床、放射学和组织学特征可能各不相同，而且可能会与其他通常预后较好的良性病变相似。我们报告一例43岁女性患者，其第三脑室病变导致脑积水，接受了病变全切手术。影像学检查和术中检查最初提示为脑膜瘤。早期手术和神经功能预后良好。该患者出现了与下丘脑功能障碍和血栓出血问题相关的多种并发症，最终因全身感染死亡。最终检查确诊为第三脑室脊索样胶质瘤。通过回顾文献，我们评估了在脊索样胶质瘤的放射学和组织学诊断以及手术和药物治疗中可能存在的陷阱。尽管其表现为良性，但据报道其多种严重并发症的发生率较高。早期警觉和联合治疗策略可能会改善脊索样胶质瘤的整体治疗策略。
