Abstract
Chordoid glioma is a rare, slow-growing neoplasm of the central nervous system. To select an appropriate surgical approach, chordoid glioma should be differentiated from other third ventricle/suprasellar tumors, such as craniopharyngiomas. In this report, we present 3 cases of chordoid glioma. Magnetic resonance images of all cases showed a round or ovoid-shaped tumor with significant enhancement with contrast medium on T1-weighted images. Moreover, preoperative T2-weighted coronal images revealed high intensity along the bilateral hypothalamus. The tumor was removed using the trans-lamina terminalis approach. Gross total resection and partial resection were achieved in 2 cases and 1 case, respectively. Immunohistochemical staining showed strong positivity for glial fibrillary acidic protein and thyroid transcription factor-1, indicating a chordoid glioma. Tumor cells also showed diffuse immunoreactivity for matrix metalloproteinase 9, indicating that the high intensity was caused by vasogenic edema. High-intensity bilateral hypothalamus on T2-weighted images is a unique feature of chordoid glioma and plays an important role in improving clinical outcomes through local tumor control and functional preservation.