1. Chordoid Gliomas
Kremer P1, Shareghi K1, Heßelmann V2, Wach J3 and Gottschalk J3
Department of Neurosurgery, Asklepios Klinik Nord/Heidberg, Hamburg1
Department or Radiology and Neuroradiology, Asklepios Klinik Nord/Heidberg, Hamburg2
Deparment of Pathology and Neuropathology, Asklepios Klinik Nord/Heidberg, Hamburg3
Klinikum Nord
Klinikum Nord

2. Chordoide Gliome
Suprasellar meningioma with expression of glial fibrillary acidic protein: a peculiar variant
Wanschitz et al.: Acta Neuropathol. 1995
Johns Hopkins Hospital
A 24-year-old female presented with a 3-year history of a suprasellar and intraventricular solid midline process measuring about 3 x 4 cm. At surgery, this tumour was sharply delineated and of stone-like firmness and was removed completely. Histology suggested meningioma, featuring nests and cords of epithelium-like cells with prominent cytoplasm amidst abundant fibrous stroma with prominent lymphoplasmocellular infiltration. Immunocytochemically, the tumour cells expressed vimentin, S-100 protein, epithelial membrane antigen, cytokeratins, and most surprisingly, glial fibrillary acidic protein (GFAP). Ultrastructural investigation revealed abundant intermediate filaments and occasionally dense secretory granules in tumour cells with short, finger-like cytoplasmic processes joined by very rare small, but well-developed desmosomes. This tumour most likely represents a peculiar variant of meningioma with prominent production of GFAP, as previously described

3. Chordoide Gliome
Third ventricular chordoid glioma: a distinct clinicopathologic entity.
Bradt et al.: J Neuropathol Exp Neurol Mar;57(3):283-90
Johns Hopkins Hospital
We have encountered a series of 8 third ventricular neoplasms with a distinctive chordoid appearance that appear to represent a clinicopathologic entity. The tumors occurred in 7 females and 1 male, ranging in age from 31 to 70 years. In all cases, imaging studies showed a large well-circumscribed third ventricular mass; a cystic component was noted in 2. The tumors consisted of cords and clusters of cohesive, oval-to-polygonal epithelioid cells with abundant eosinophilic cytoplasm, relatively uniform round-to-oval nuclei, and inconspicuous nucleoli. Mitotic activity was absent. The stroma consisted of scant, coarse fibrillar processes, as well as prominent, slightly basophilic, extracellular mucin resembling that in chordomas. Throughout the tumor, and surrounding its well-defined borders, were infiltrates of mature lymphocytes and plasma cells. Russell bodies were prominent in the latter. Adjacent brain tissue showed reactive changes with gliosis and numerous Rosenthal fibers. Immunohistochemically, tumor cells were strongly reactive for GFAP and vimentin, but negative or only weakly staining for EMA. The MIB-1 labeling index was approximately 1%. Ultrastructural examination of 4 cases revealed focal microvilli, scattered "intermediate" junctions, and focal basal lamina formation. Neither desmosomes nor cilia were seen. Total resections were achieved in 2 cases; only subtotal removals were achieved in 6. Subsequent tumor enlargement was noted in 3 of the 6 patients with incomplete resection, and of these, two died at post-operative intervals of 8 months and 3 years. The other patient survives 4 years post-operatively with stable residual disease. Of the 2 patients with total resection, 1 was lost to follow-up; the other, during a brief follow-up period, did well without evidence of recurrence.

4. Chordoide Gliome: Histopathologie

5. Chordoide Gliome: Histopathologie

6. Chordoide Gliome: Klinischen Symptome

7. Chordoide Gliome: Altersverteilung

8. Chordoide Gliome: Geschlechtsverteilung

9. Chordoide Gliome: Bildgebung

10. Chordoide Gliome: Bildgebung

11. Chordoide Gliome: Bildgebung

12. Chordoide Gliome: Bildgebung

13. Chordoide Gliome: Differentialdiagnosen
Meningeom
Pilocytisches Astrozytom
Kraniopharyngeom
Germinom
Papillom des Plexus chorioideus
Kolloidzyste
Cerebrales Lymphom
Chondrom
Ependymom
Neuroblastom
Zentrales Neurozytom

14. Chordoide Gliome
Patienten: 2 x weiblich (40 und 67 J.) 1 x männlich (44 J.) 1 x Diabetes insipidus 1 x hochgradiger Visusminderung 1 x zufällig Operativer Zugang: 3 x subfrontal Behandlungsergebnis: 2 x komplette Exstirpation ohne Defizit 1 x inkomplette Exstirpation mit Zunahme der Sehverschlechterung

15. Chordoide Gliome: Immunhistochemie

16. Chordoide Gliome: Postoperative Komplikationen

17. Chordoide Gliome:
Seltene Tumoren Rein supraselläre Lage, sehr scharf begrenzt Solides, homogenes Enhancement Unklarer Ursprung Rücksprache mit Neurpathologen

18. Klinikum Nord