Chordoid glioma in the thalamus of a child: Rare location and atypical imaging findings

Abstract

Chordoid glioma is a rare intracranial tumour, which usually occurs in middle-aged female patients, mainly in the third ventricle, hypothalamus and suprasellar region. It can reportedly occur in the temporal-parietal lobe, occipital horn of the lateral ventricle and left thalamus. Here, we report a case of chordoid glioma in the thalamic region of a female child, which is different from the previously reported chordoid glioma in the left thalamus. Given its atypical location and imaging findings, it is often misdiagnosed as low-grade glioma before operation. Through the study of this case, we recognized the atypical imaging manifestations of chordoid glioma in a rare location.

Figure 1.

Computed tomography of the tumour (long white arrow). CT revealed an oval low-density mass in the right thalamus.

Figure 2.

(A-F) Magnetic resonance images of the tumour (long white arrow). A and B, T1WI shows a well-defined solid cystic mass in the right thalamus. In the cystic part (pentagram), T1WI shows hypointensity, T2WI shows hyperintensity and slightly hyperintense nodules (white dotted arrow) are visible in the centre. The solid part (short white arrow) shows slight hypointensity in T1WI and slight hyperintensity in T2WI. C, Axial FLAIR shows slight hyperintensity in the cystic area and the central nodule, and the solid part shows hyperintensity. D and E, The lesion shows no diffusion restriction on diffusion-weighted imaging (DWI) and on the apparent diffusion coefficient map. F, Axial T1WI enhancement shows the annular enhancement of central nodule. (MRI = magnetic resonance imaging, T1WI = T₁-weighted1-weighted images, and T2WI = T₂-weighted2-weighted images).

Figure 3.

Postoperative computed tomography (CT) examination. The CT image shows that most of the tumours were resected and a little blood oozed in the operative area.

Figure 4.

Histological examination of the chordoid glioma. A, Hematoxylin and eosin staining shows that the tumour cells were sparse, the arrangement was dense, the atypia was not obvious, there was no obvious proliferation of blood vessels, some of the tumour cells had degenerated, and there was interstitial myxoid degeneration (HE,×100). B, Immunohistochemical analyses of the tumour cells showing positive staining for GFAP (×40).