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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(01): 127-131
DOI: 10.1055/s-0041-1741044
Case Report

A Cystic Clival Chordoma with CT and MRI Unconventional Appearances

Pamela Guadalupi
1   UOC Radiodiagnostica e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2   UOC Radiodiagnostica e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
,
Marco Gessi
3   Neuropathology Unit, Division of Pathology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
,
Luca Massimi
4   Pediatric Neurosurgery Unit, Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
5   Pediatric Neurosurgery Unit, Department of Neurosurgery, Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
,
Massimo Caldarelli
4   Pediatric Neurosurgery Unit, Department of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
5   Pediatric Neurosurgery Unit, Department of Neurosurgery, Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
,
Simona Gaudino
1   UOC Radiodiagnostica e Neuroradiologia, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Abstract

We present the first case of clival cystic chordoma with extradural location, transdural transgression, and moderate bone involvement in a 10-year-old girl. Chordoma showed unconventional appearances on computed tomography (CT) and magnetic resonance imaging (MRI), due to cystic components, extradural space location with extensive intradural extension, moderate superficial bone involvement. Surgery confirmed the extradural location and histopathological examination revealed cystic chordoma. MRI and CT findings were not characteristic for a single lesion; differential diagnoses included cystic lesions such as epidermoid and dermoid cyst, ecchordosis physaliphora, and benign notochordal cell tumors.

Keywords

chordoma - CT - cystic - extradural - MRI - transdural

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.


Financial Support and Sponsorship

Nil.




Publication History

Article published online:
28 February 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Erdem E, Angtuaco EC, Van Hemert R, Park JS, Al-Mefty O. Comprehensive review of intracranial chordoma. Radiographics 2003; 23 (04) 995-1009
    CrossrefPubMedSearch in Google Scholar
  • 2 Doucet V, Peretti-Viton P, Figarella-Branger D, Manera L, Salamon G. MRI of intracranial chordomas. Extent of tumour and contrast enhancement: criteria for differential diagnosis. Neuroradiology 1997; 39 (08) 571-576
    CrossrefPubMedSearch in Google Scholar
  • 3 Batista KMP, Reyes KYA, Lopez FP. et al. Immunophenotypic features of dedifferentiated skull base chordoma: an insight into the intratumoural heterogeneity. Contemp Oncol (Pozn) 2017; 21 (04) 267-273
    PubMedSearch in Google Scholar
  • 4 Wu Z, Zhang J, Zhang L. et al. Prognostic factors for long-term outcome of patients with surgical resection of skull base chordomas-106 cases review in one institution. Neurosurg Rev 2010; 33 (04) 451-456
    CrossrefPubMedSearch in Google Scholar
  • 5 Wu Z, Wang L, Guo Z. et al. Experimental study on differences in clivus chordoma bone invasion: an iTRAQ-based quantitative proteomic analysis. PLoS One 2015; 10 (03) e0119523
    CrossrefPubMedSearch in Google Scholar
  • 6 Santegoeds RGC, Temel Y, Beckervordersandforth JC, Van Overbeeke JJ, Hoeberigs CM. State-of-the-art imaging in human chordoma of the skull base. Curr Radiol Rep 2018; 6 (05) 16
    CrossrefPubMedSearch in Google Scholar
  • 7 Müller U, Kubik-Huch RA, Ares C. et al. Is there a role for conventional MRI and MR diffusion-weighted imaging for distinction of skull base chordoma and chondrosarcoma?. Acta Radiol 2016; 57 (02) 225-232
    CrossrefPubMedSearch in Google Scholar
  • 8 Osborn AG, Preece MT. Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology 2006; 239 (03) 650-664
    CrossrefPubMedSearch in Google Scholar
  • 9 Mehnert F, Beschorner R, Küker W, Hahn U, Nägele T. Retroclival ecchordosis physaliphora: MR imaging and review of the literature. AJNR Am J Neuroradiol 2004; 25 (10) 1851-1855
    PubMedSearch in Google Scholar
  • 10 Oikawa S, Kyoshima K, Goto T. et al. Histological study on local invasiveness of clival chordoma. Case report of autopsy. Acta Neurochir (Wien) 2001; 143 (10) 1065-1069
    CrossrefPubMedSearch in Google Scholar
  • 11 Lagman C, Varshneya K, Sarmiento JM, Turtz AR, Chitale RV. Proposed diagnostic criteria, classification schema, and review of literature of notochord-derived ecchordosis physaliphora. Cureus 2016; 8 (03) e547
    PubMedSearch in Google Scholar
  • 12 Nishiguchi T, Mochizuki K, Ohsawa M. et al. Differentiating benign notochordal cell tumors from chordomas: radiographic features on MRI, CT, and tomography. AJR Am J Roentgenol 2011; 196 (03) 644-650
    CrossrefPubMedSearch in Google Scholar
  • 13 Niida H, Tanaka R, Tamura T, Takeuchi S. Clival chordoma in early childhood without bone involvement. Childs Nerv Syst 1994; 10 (08) 533-535
    CrossrefPubMedSearch in Google Scholar
  • 14 Nishigaya K, Kaneko M, Ohashi Y, Nukui H. Intradural retroclival chordoma without bone involvement: no tumor regrowth 5 years after operation. Case report. J Neurosurg 1998; 88 (04) 764-768
    CrossrefPubMedSearch in Google Scholar
  • 15 Seung WB, Kim SM. Clival cystic chordoma in children with confused magnetic resonance imaging. J Korean Neurosurg Soc 2004; 36: 422-424
    Search in Google Scholar
  • 16 Ciarpaglini R, Pasquini E, Mazzatenta D, Ambrosini-Spaltro A, Sciarretta V, Frank G. Intradural clival chordoma and ecchordosis physaliphora: a challenging differential diagnosis: case report. Neurosurgery 2009; 64 (02) E387-E388 , discussion E388
    CrossrefPubMedSearch in Google Scholar
  • 17 Cho H, Yu IK, Kim SM, Kim HK. Magnetic resonance imaging of the intradural prepontine chordoma mimicking an epidermoid cyst: pathologic correlation. J Korean Soc Radiol 2012; 67 (02) 73-77
    CrossrefSearch in Google Scholar
  • 18 Hashim H, Rosman AK, Abdul Aziz A, Roqiah AK, Bakar NS. Atypical clival chordoma in an adolescent without imaging evidence of bone involvement. Malays J Med Sci 2014; 21 (05) 78-82
    PubMedSearch in Google Scholar
  • 19 AlOtaibi F, Guiot M-C, Muanza T, Di Maio S. Giant petroclival primary intradural chordoma: case report and systematic review of the literature. J Neurol Surg Rep 2014; 75 (01) e160-e169
    Thieme ConnectPubMedSearch in Google Scholar
  • 20 Ozek E, Bolukbasi FH, Baskan O, Altinoz MA, Sav A, Elmaci I. Prepontine chordoma presenting with MRI features of an epidermoid cyst: case presentation and a mini-review. Curr Med Imaging Rev 2018; 14: 147-150
    CrossrefSearch in Google Scholar
  • 21 Vinke RS, Lamers EC, Kusters B, van Lindert EJ. Intradural prepontine chordoma in an 11-year-old boy. A case report. Childs Nerv Syst 2016; 32 (01) 169-173
    CrossrefPubMedSearch in Google Scholar
  • 22 Kim MJ, Park YW, Lim SM. Imaging findings of a nonenhancing intradural paramedian chordoma mimicking an epidermoid cyst. Korean J Radiol 2018; 79: 175-180
    CrossrefSearch in Google Scholar
  • 23 Sathe P, Mahore A, Chagla A. Cystic chordoma of the cavernous sinus. Turk Neurosurg 2019; 29 (02) 300-302
    PubMedSearch in Google Scholar
  • 24 Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics 2003; 23 (05) 1245-1278
    CrossrefPubMedSearch in Google Scholar