A Case Report of Chordoma Presenting as a Sphenoid Sinus Mass: A Diagnostic
Challenge

Bharti, Jyotsna Naresh

doi:10.2174/1573405618666220901123032

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…These cases described herein highlight the diagnostic challenges associated with ISFS, which can mimic other pathologies such as chordoma on preoperative imaging [4][5][6]. Mucocele and fungal ball commonly exhibit low signal intensity on both T1-and T2-weighted imaging.…”

Section: Discussionmentioning

confidence: 84%

Isolated Sphenoid Fungal Sinusitis With Mucocele Mistaken for Chordoma: A Study of Two Unique Cases

Nam,

Seo

2024

J Rhinol

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Isolated sphenoid fungal sinusitis (ISFS) is a rare condition characterized by fungal infection of the sphenoid sinus. It often presents with non-specific symptoms, which can lead to misdiagnosis. This study presents two unique cases of ISFS with mucocele that were initially misdiagnosed as chordoma based on preoperative radiographic findings. Two cases of ISFS were thoroughly investigated, including clinical examinations, radiological assessments, and surgical explorations. The patients’ symptoms, radiographic findings, surgical procedures, and postoperative outcomes were documented. In both cases, radiographic assessments raised suspicion of chordoma due to bony destruction and soft tissue lesions involving the sphenoid sinus and clivus. However, endoscopic sinus surgery revealed fungal balls and mucoceles, confirming the diagnosis of ISFS. Postoperative pathology confirmed the presence of aspergilloma. The patients recovered well with appropriate treatment. ISFS is challenging to diagnose due to its deep anatomical location and non-specific symptoms. Visual disturbances, particularly affecting the abducens nerve, are common. Sphenoid sinus mucocele, though rare, can be present. Surgical exploration plays a crucial role in establishing an accurate diagnosis and initiating appropriate treatment. ISFS can mimic other skull base lesions, such as chordoma, on preoperative radiography. These cases underscore the value of surgical exploration in reaching an accurate diagnosis and highlight the need for the cautious interpretation of radiological findings in sphenoid sinus lesions to ensure optimal patient care.

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Section: Discussionmentioning

confidence: 84%

Isolated Sphenoid Fungal Sinusitis With Mucocele Mistaken for Chordoma: A Study of Two Unique Cases

Nam,

Seo

2024

J Rhinol

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“…[ 21 ] The tumor is locally aggressive and has a high tendency to recur. [ 19 ] As the notochord is a midline structure ultimately giving rise to the vertebrae and basiocciput, chordoma typically involves these structures and is situated extradurally;[ 4 , 10 ] approximately 50% of them develop in the sacrococcygeal region, 35% in the clivus, and 15% in the other vertebrae. [ 32 ] Although intracranial chordomas exclusively arise in the clivus or the craniovertebral junction,[ 18 ] they can rarely arise inside the sella turcica.…”

Section: Introductionmentioning

confidence: 99%

Intrasellar chordoma masquerading as a pituitary neuroendocrine tumor: Illustrative case

Sato,

Hasegawa,

Kimura

et al. 2024

Surgical Neurology International

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Background: Chordomas are rare, locally aggressive neoplasms recognized as derivatives of the notochord vestiges. These tumors typically involve the midline axial skeleton, and intracranial chordomas exhibit proclivity for the spheno-occipital region. However, purely intrasellar occurrences are extremely rare. We report a case of intrasellar chordoma, which masqueraded as a pituitary neuroendocrine tumor. Case Description: An 87-year-old female presented with an acutely altered mental state after a few-week course of headaches and decreased left vision. Adrenal insufficiency was evident, and magnetic resonance imaging revealed an intrasellar lesion with heterogeneous contrast enhancement and marked T2 hyperintensity. Central adrenal insufficiency due to an intrasellar lesion was suspected. Cortisol replacement was initiated, and transsphenoidal surgery was performed. Anterosuperior displacement of the normal pituitary gland and the absence of the bony dorsum sellae were notable during the procedure. Histological examination led to a diagnosis of conventional chordoma, and upfront adjuvant stereotactic radiosurgery was executed. She has been free from tumor progression for 12 months. Conclusion: This case and literature review suggested that the pathognomonic features of intrasellar chordoma were heterogeneous contrast enhancement, marked T2 hyperintensity, osteolytic destruction of the dorsum sellae, and anterosuperior displacement of the pituitary gland. Clinical outcomes seemed slightly worse than those of all skull base chordomas, which were the rationale for upfront radiosurgery in our case. Neurosurgeons should include intrasellar chordomas in the differential diagnosis of intrasellar lesions, carefully dissect them from the adjacent critical anatomical structures, and consider upfront radiosurgery to achieve optimal patient outcomes.

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A Case Report of Chordoma Presenting as a Sphenoid Sinus Mass: A Diagnostic Challenge

Cited by 2 publications

References 16 publications

Isolated Sphenoid Fungal Sinusitis With Mucocele Mistaken for Chordoma: A Study of Two Unique Cases

Isolated Sphenoid Fungal Sinusitis With Mucocele Mistaken for Chordoma: A Study of Two Unique Cases

Intrasellar chordoma masquerading as a pituitary neuroendocrine tumor: Illustrative case

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