Intradural Retroclival Chordoma Without Bone Involvement-Case Report-

Abstract

A 63-year-old, previously healthy man presented with a rare large intradural retroclival chordoma without bone involvement. Computed tomography showed that the tumor was completely intradural and did not involve the bone, as confirmed at intraoperative inspection. The tumor was totally excised via the anterior transpetrosal approach. Surgery is the most effective first-line treatment for patients with chordoma despite the typical extradural extension and bone destruction. Complete resection is feasible for intradural extraosseous chordoma because of the sharply circumscribed margins and absence of bone involvement. Specialized skull base techniques should be used instead of conventional surgical approaches for intradural skull base chordoma.

Chordoma Arising from Cranial Base Extending to Oropharynx: An Unusual Presentation

“…X-ray films may reveal a lobulated soft tissue mass projecting into the vault of the nasopharynx as in our patient. The classic appearance of extraosseous chordoma is well-circumscribed, lobular hypoattenuated, expansile soft-tissue mass that arises from the clivus with associated extensive lytic bone destruction, sometimes dystrophic calcifications [10]. These classic features were present in above case.…”

Extraosseous Chordoma of the Nasopharynx

“…[1][2][3][4] Intracranial chordomas generally occur in the vicinity of the clivus, often in the region of the spheno-occipital synchondrosis. There have been case reports of extraosseous chordomas in the literature, but none have been reported in the nasopharynx, as defined in our series.…”

“…There have been case reports of extraosseous chordomas in the literature, but none have been reported in the nasopharynx, as defined in our series. 2,3 It is important to consider extraosseous chordoma in the differential diagnosis of tumors in the nasopharynx because it requires a very different treatment plan and carries its own unique prognosis.…”

“…Scattered areas of hyperattenuation are consistent with descriptions in the literature of blood products and intratumoral hemorrhage in typical chordomas. [1][2][3] The interesting feature in our series is a sinus tract along the expected course of the notochordal remnant. The associated midline bony tract is an important clue to the notochordal origin of this extraosseous chordoma because other nasopharyngeal malignancies may destroy clival bone but do not demonstrate this midline tract.…”

A Case of Extraosseous Chordoma at the Cervico-Thoracic Junction

“…Both CT and MR imaging are used in the evaluation of chordoma, but MR imaging is considered the gold standard [6].…”