Chordoid Glioma with Psychosis: Case Report. 2018

Samuel Estronza, and Fanor M Saavedra, and Orlando De Jesus, and Emil A Pastrana
Neurosurgery Section, Department of Surgery, University of Puerto Rico Medical Sciences Campus, San Juan, PR.

A rare, low-grade tumor found in the hypothalamus and anterior third ventricle, a chordoid glioma presents a challenge to neurosurgeons: Its successful resection is complicated by its inconvenient location. A 42-year-old male patient presented with a 1-year history of major depressive disorder, with psychotic features associated with generalized tonic-clonic seizures. Brain magnetic resonance imaging (MRI) with contrast revealed a suprasellar mass extending into the third ventricle To resect the lesion, an interhemispheric transcallosal transventricular subfornical approach was used. Pathology revealed a chordoid glioma. The patient had a complicated post-operative period that included the development of neurogenic diabetes insipidus, followed by intractable hyponatremia and death (caused by malignant brain edema). A chordoid glioma is a rare neoplasm that, in 2000, was incorporated into the World Health Organization (WHO) classification of central nervous system tumors. Due to its rarity, it is seldom considered in the differential diagnosis of suprasellar masses. Moreover, its unusual presentation and difficult location present a challenge for surgical and medical management.

UI MeSH Term Description Entries
D007029 Hypothalamic Neoplasms Benign and malignant tumors of the HYPOTHALAMUS. Pilocytic astrocytomas and hamartomas are relatively frequent histologic types. Neoplasms of the hypothalamus frequently originate from adjacent structures, including the OPTIC CHIASM, optic nerve (see OPTIC NERVE NEOPLASMS), and pituitary gland (see PITUITARY NEOPLASMS). Relatively frequent clinical manifestations include visual loss, developmental delay, macrocephaly, and precocious puberty. (From Devita et al., Cancer: Principles and Practice of Oncology, 5th ed, p2051) Hypothalamic Tumors,Hypothalamic-Chiasmatic Neoplasms,Hypothalamic-Pituitary Neoplasms,Benign Hypothalamic Neoplasms,Hypothalamic Cancer,Hypothalamic Neoplasms, Benign,Hypothalamic Neoplasms, Malignant,Hypothalamic Teratomas,Hypothalamo-Neurohypophysial Region Neoplasms,Hypothalamus Neoplasms,Malignant Hypothalamic Neoplasms,Neoplasms, Hypothalamic,Neoplasms, Hypothalamic, Benign,Neoplasms, Hypothalamic, Malignant,Neoplasms, Hypothalamic-Chiasmatic,Neoplasms, Hypothalamic-Pituitary,Neoplasms, Hypothalamo-Neurohypophysial Region,Neoplasms, Hypothalamus,Tumors, Hypothalamus,Benign Hypothalamic Neoplasm,Cancer, Hypothalamic,Cancers, Hypothalamic,Hypothalamic Cancers,Hypothalamic Chiasmatic Neoplasms,Hypothalamic Neoplasm,Hypothalamic Neoplasm, Malignant,Hypothalamic Pituitary Neoplasms,Hypothalamic Teratoma,Hypothalamic Tumor,Hypothalamic-Chiasmatic Neoplasm,Hypothalamic-Pituitary Neoplasm,Hypothalamo Neurohypophysial Region Neoplasms,Hypothalamo-Neurohypophysial Region Neoplasm,Hypothalamus Neoplasm,Hypothalamus Tumor,Hypothalamus Tumors,Malignant Hypothalamic Neoplasm,Neoplasm, Benign Hypothalamic,Neoplasm, Hypothalamic,Neoplasm, Hypothalamic-Chiasmatic,Neoplasm, Hypothalamic-Pituitary,Neoplasm, Hypothalamo-Neurohypophysial Region,Neoplasm, Hypothalamus,Neoplasm, Malignant Hypothalamic,Neoplasms, Hypothalamic Chiasmatic,Neoplasms, Hypothalamic Pituitary,Neoplasms, Hypothalamo Neurohypophysial Region,Neoplasms, Malignant Hypothalamic,Teratoma, Hypothalamic,Teratomas, Hypothalamic,Tumor, Hypothalamic,Tumor, Hypothalamus,Tumors, Hypothalamic
D008297 Male Males
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D005910 Glioma Benign and malignant central nervous system neoplasms derived from glial cells (i.e., astrocytes, oligodendrocytes, and ependymocytes). Astrocytes may give rise to astrocytomas (ASTROCYTOMA) or glioblastoma multiforme (see GLIOBLASTOMA). Oligodendrocytes give rise to oligodendrogliomas (OLIGODENDROGLIOMA) and ependymocytes may undergo transformation to become EPENDYMOMA; CHOROID PLEXUS NEOPLASMS; or colloid cysts of the third ventricle. (From Escourolle et al., Manual of Basic Neuropathology, 2nd ed, p21) Glial Cell Tumors,Malignant Glioma,Mixed Glioma,Glial Cell Tumor,Glioma, Malignant,Glioma, Mixed,Gliomas,Gliomas, Malignant,Gliomas, Mixed,Malignant Gliomas,Mixed Gliomas,Tumor, Glial Cell,Tumors, Glial Cell
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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