Intradural clival chordoma and ecchordosis physaliphora: a challenging differential diagnosis: case report.
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.


METHODS
A 60-year-old man presenting with memory loss underwent magnetic resonance imaging, which revealed an intradural retroclival mass without bone involvement.


METHODS
The patient underwent an endoscopic transsphenoidal-transclival procedure with subtotal removal of the tumor. Histological findings confirmed the diagnosis of a chordoma.


CONCLUSIONS
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.
Ciarpaglini
Riccardo
R
Center of Surgery for Pituitary Tumours and Endoscopic Skull Base Surgery, Neurosurgical Department, Bellaria Hospital, Bologna, Italy.
Pasquini
Ernesto
E
Mazzatenta
Diego
D
Ambrosini-Spaltro
Andrea
A
Sciarretta
Vittorio
V
Frank
Giorgio
G
D020295:Brain Stem Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D002817:Chordoma / Q000737:chemistry / Q000175:diagnosis* / Q000628:therapy*; D003388:Cranial Fossa, Posterior / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*