Endoscopic Removal of Clival Chordoma

Abstract

Clivus chordomas are locally aggressive benign, with primary bone tumor arising from remnant of notochord anywhere from the coccyx to the base of the skull, in either a midline or paramedian position. The tumors show rare presentation and relatively common recurrence rate. Intracranial chordomas usually arise from the region around the clivus and account for about a third of all chordomas. Clival chordomas rarely metastasize and become symptomatic after local invasion to cranial nerves and skull base structure. Diagnosis is based on computed tomography scan/magnetic resonance imaging findings and histopathological examination of soft tissue mass. Complete surgical resection is the primary line of management with or without radiotherapy. We are presenting a case of clival chordoma of a 35-year-old female who presented with diminished vision and headache since 6 months. After evaluation, the patient was treated with endoscopic endonasal transsphenoidal resection of the tumor. After surgery, the patient showed relief from headache and slight improvement in vision loss.