Intradural clival chordoma and ecchordosis physaliphora: A challenging differential diagnosis: Case report

Riccardo Ciarpaglini, Ernesto Pasquini, Diego Mazzatenta, Andrea Ambrosini-Spaltro, Vittorio Sciarretta, Giorgio Frank

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)387-388
Number of pages2
JournalNeurosurgery
Volume64
Issue number2
DOIs
Publication statusPublished - Feb 2009

Keywords

  • Ecchordosis physaliphora
  • Endoscopy
  • Extended transsphenoidal approach
  • Intradural clival chordoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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