Clival and Paraclival Lesions: A Pictorial Review

Palsetia, Delnaz; Vijan, Antariksh; Gala, Foram; Sahu, Amit C.; Patkar, Deepak; Sahu, Arpita

doi:10.1055/s-0043-1761183

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…A locally invasive clival lesion may arise from notochord-derived tumors (such as chordoma, chondromas, chondrosarcomas) and hematologic malignant tumors (myeloma, lymphoma, Langerhans cell histiocytosis), which are centered within the clivus. Less commonly, invasive pituitary adenomas may secondarily involve the clival region, typically occurring in older adults [1]. Rarely, clival metastases from head, neck, abdominal, and thoracic malignancies may be considered.…”

Section: Introductionmentioning

confidence: 99%

Managing a Complex Pituitary Tumor: A Case Study on Effective Diagnosis and Treatment of a Challenging Clival Lesion

Fong,

Low,

Lee

et al. 2024

AOHNS

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Clival lesions are diverse and can be classified into primary, originating from notochordal or hematologic derivatives, or secondary tumors arising from the pituitary gland. Clival metastases are rare. The aim of imaging clival lesions is to delineate the disease's epicenter. However, it may not consistently differentiate between diagnoses in locally invasive lesions. We describe a challenging case involving a 51-year-old Chinese female who presented with atypical symptoms of headache and nasal pain. Initial computed tomography and magnetic resonance imaging findings revealed an invasive lesion of the clivus, supporting a diagnosis of either chordoma or chondrosarcoma. A definitive diagnosis was obtained through a transsphenoidal biopsy, which identified the lesion as a pituitary neuroendocrine tumor. The lesion was subsequently completely excised without postoperative complications. This case underscores the necessity of mandatory biopsy for invasive clival lesions, especially those presenting with atypical imaging features, rather than solely relying on imaging for diagnosis. In the era of minimally invasive transnasal endoscopic techniques, these diagnostic approaches routinely achieve a high diagnostic yield and must be considered to guide further treatment and prognosis.

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Section: Introductionmentioning

confidence: 99%

Managing a Complex Pituitary Tumor: A Case Study on Effective Diagnosis and Treatment of a Challenging Clival Lesion

Fong,

Low,

Lee

et al. 2024

AOHNS

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“…The clivus is a midline anatomical structure in the central skull base. It is affected by a wide range of non-neoplastic, benign, and malignant pathologies, some of which typically affect the clivus because of its strategic location and embryological origins [ 1 ]. Clival chondromas are rare, benign tumors characterized by the growth of hyaline cartilage in the clivus.…”

Section: Introductionmentioning

confidence: 99%

Rare Case of a Clival Chondroma Resulting in Panhypopituitarism

Yetiskul,

Grabie,

Hassan

et al. 2023

Cureus

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Chondromas are rare benign tumors composed of hyaline cartilage that can arise in various locations in the body. Their occurrence in the clivus, leading to panhypopituitarism, is exceptionally rare. This case report describes a 93-year-old female with a known clival chondroma who presented with altered mental status, presumed to be secondary to toxic metabolic encephalopathy due to an infectious cause. Further diagnostic evaluation revealed pituitary hormone levels below the normal range. This case report aims to highlight a unique case of panhypopituitarism attributed to a chondroma in the clivus with tumor extension to the sellar region, emphasizing the diagnostic challenges and treatment options for this unusual pathology.

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Combined microscopic transoral and endoscopic endonasal approach for a clival chordoma: A case report and literature review

Munuzuri-Camacho,

Palacios-Rodriguez,

Alanis-Mendizabal

et al. 2024

Surgical Neurology International

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Background: Chordomas are primary bone tumors derived from the embryonic notochord. They represent 1–4% of all malignant bone tumors. They have a predominantly extra-axial location, arising in the clival region in 35% of reported cases. The prognosis is generally poor, and radical resection remains the first-line treatment. This study aims to describe a case of a clival chordoma that was resected through a combined microscopic transoral and endoscopic endonasal approach, with excellent clinical outcomes. Case Description: A 24-year-old woman with low cranial nerve symptomatology was admitted for a two-stage surgical approach. An occipital-cervical fixation was performed in the first stage, while a combined endonasaltransoral resection was performed later for tumor resection. Conclusion: Microscopic transoral and endoscopic endonasal approaches offer advantages for treating clival chordomas, with careful consideration of anatomical constraints and potential for postoperative recurrence being essential in approach selection.

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Clival and Paraclival Lesions: A Pictorial Review

Cited by 3 publications

References 39 publications

Managing a Complex Pituitary Tumor: A Case Study on Effective Diagnosis and Treatment of a Challenging Clival Lesion

Managing a Complex Pituitary Tumor: A Case Study on Effective Diagnosis and Treatment of a Challenging Clival Lesion

Rare Case of a Clival Chondroma Resulting in Panhypopituitarism

Combined microscopic transoral and endoscopic endonasal approach for a clival chordoma: A case report and literature review

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