[A Case of Intradural Retroclival Chordoma]

No Shinkei Geka. 2017 Jul;45(7):623-627. doi: 10.11477/mf.1436203561.
[Article in Japanese]

Abstract

A 67-year-old woman was referred to our department with a retroclival lesion including a cyst on MRI. MRI revealed a lesion appearing as an isointense region on a diffusion-weighted image(DWI). Gadolinium(Gd)-DTPA T1-WI showed heterogeneous enhancement of the lesion in the prepontine cistern. Computed tomography(CT)revealed an isodense lesion with no invasion into the clival bone. Based on a preoperative diagnosis of retroclival chordoma, extended trans-sphenoidal surgery(TSS)was performed by a direct endoscopic endonasal approach via the left nostril. We found a round dural defect with a diameter of 5 mm, through which the tumor was incarcerated. However, the tumor had no connection to the clival bone. The lesion was totally removed and histologically diagnosed as a chordoma. Furthermore, the clival bone included no tumor cells. Based on those radiological and histological findings, we diagnosed the lesion as an intradural retroclival chordoma. We should consider intradural retroclival chordoma as a candidate for the differential diagnosis of a retroclival lesion without clival bone invasion.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chordoma / diagnostic imaging*
  • Chordoma / surgery*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Multimodal Imaging
  • Skull Neoplasms / diagnostic imaging*
  • Skull Neoplasms / pathology
  • Skull Neoplasms / surgery*
  • Tomography, X-Ray Computed