Third Ventricle Anaplastic Oligodendroglioma: A Case Report

Oligodendroglioma (ODG) constitutes 0.9- 4% of all brain tumours and are relatively rare tumours in pediatric age group constituting 6.5% cases with mean age 12 +/- 6 years . They are most common in frontal and temporal lobes however rare cases of Intraventricular ODG are reported. Most commonly they arises from anterior part of lateral ventricles.  Third ventricle ODG is extremely rare and only few cases of lateral and third ventricle anaplastic ODG are reported. ODG infiltrate locally to meninges and rarely have leptomeningeal spread. Anaplastic ODG constitutes 24% of all pediatric ODG. Thus ODG forms an differential diagnosis of pediatric intraventricular tumour and unlike other intraventricular tumours have low propensity for spinal metastasis.

Here we present a case of 15 months old  male child with obstructive hydrocephalus who presented with features of raised intracranial pressure. Patient was detected to be COVID-19 RT -PCR positive in preoperative evaluation. He underwent emergency Right sided Ventriculo peritoneal shunt and later his contrast MRI Brain was done which showed a 50X24X39 mm heterogenously enhancing mass epicentred at third ventricle and extending to lateral and fourth ventricle with spinal drop metastasis. Pre operative differntial diagnosis of Ependymoma was made and  definitive surgery was done once child recovered from COVID-19. However his biopsy and Immunohistochemistry was suggestive of oligodendoglioma and child responded well to chemotherapy.

Although extremely rare intraventricular oligodendroglioma should be kept as a differntial in pediatric intraventricular space occupying lesion as they have low chances of leptomeningeal spread and better response to adjuvant chemotherapy.