OBJECTIVE: Purely intradural clival chordomas are rare neoplasms, and only a few cases have been reported. The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique. CLINICAL PRESENTATION: A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement. INTERVENTION: The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma. CONCLUSION: Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only if a regrowth of the remnant is seen during neuroradiological follow-up.
OBJECTIVE: Purely intradural clival chordomas are rare neoplasms, and only a few cases have been reported. The reported cases present features similar to ecchordosis physaliphora, which is a notochordal remnant. We describe these 2 entities and their differential diagnoses, clinical courses, and management. This is the first reported case to be treated using a neuroendoscopic technique. CLINICAL PRESENTATION: A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement. INTERVENTION: The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma. CONCLUSION: Even if some parameters exist for a differential diagnosis, ecchordosis physaliphora and intradural chordoma may represent different aspects of the spectrum of the same pathology. Intradural clival chordomas have a better prognosis with respect to classic chordomas. Therefore, in subtotal removal such as that performed in our case, postoperative radiation therapy should be performed only if a regrowth of the remnant is seen during neuroradiological follow-up.
Authors: Francesco Belotti; Francesco Tengattini; Davide Mattavelli; Marco Ferrari; Antonio Fiorentino; Silvia Agnelli; Alberto Schreiber; Piero Nicolai; Marco Maria Fontanella; Francesco Doglietto Journal: Neurosurg Rev Date: 2020-02-14 Impact factor: 3.042
Authors: Aïsha Sooltangos; Istvan Bodi; Prajwal Ghimire; Konstantinos Barkas; Sinan Al-Barazi; Nick Thomas; Eleni C Maratos Journal: J Neurol Surg B Skull Base Date: 2021-03-12
Authors: Sung-Joo Yuh; John Woulfe; Martin J Corsten; Ricardo L Carrau; Daniel M Prevedello; Amin B Kassam Journal: J Neurol Surg B Skull Base Date: 2014-03-03