-Case Report-

A Case of Chordoid Glioma Complicated by an Anterior Communicating Artery Aneurysm Treated with Single-Stage Surgery Combining an Interhemispheric Approach and Endoscopic Transsphenoidal Surgery

Taisei Aoki¹, Yohei Nounaka¹, Fumihiro Matano¹, Koshiro Isayama¹, Asami Kubota¹, Tadashi Higuchi¹ and Shigeyuki Tahara²

¹Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
²Department of Neurological Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan

Chordoid glioma (CG) is an extremely rare low-grade tumor arising from the suprasellar region. Here, we report a case of CG complicated by an anterior communicating artery aneurysm in a 51-year-old man. The patient underwent a single-stage surgery combining endoscopic transsphenoidal surgery (ETSS) and open craniotomy to clip the aneurysm. CG is typically confined to the third ventricle, but in this case the tumor reached the prepontine cistern and clivus. To decrease the risk of aneurysmal rupture during tumor resection, simultaneous clipping of the aneurysm via craniotomy was performed. Tumor resection was primarily conducted using ETSS, with support provided from the craniotomy side. The extent of tumor resection was favorable, and the patient's vision improved after surgery. However, he later developed complications, including diabetes insipidus and cognitive dysfunction. To our knowledge, this is the first report of combined surgery for CG and highlights the potential of ETSS, thereby providing valuable insights for future treatment strategies.

J Nippon Med Sch 2026; 93: 338-344

Keywords
cerebral ventricle neoplasms, craniotomy, glioma, intracranial aneurysm, third ventricle

Correspondence to
Taisei Aoki
t-aoki@nms.ac.jp

Received, November 23, 2024
Accepted, February 21, 2025