title: Clival chordoma with an atypical presentation: a case report.
abstract: BACKGROUND
  Clival chordomas present with headache, commonly VI cranial nerve palsy or sometimes with lower cranial nerve involvement. Very rarely, they present with cerebrospinal fluid rhinorrhoea due to an underlying chordoma-induced skull base erosion.
  
  
  METHODS
  A 60-year old Caucasian woman presented with meningitis secondary to cerebrospinal fluid rhinorrhoea. At first, radiological imaging did not reveal a tumoral condition, though intraoperative exploration and tissue histology revealed a chordoma which eroded her clivus and had a transdural extension.
  
  
  CONCLUSIONS
  Patients who present with meningitis and cerebrospinal fluid rhinorrhoea could have an underlying erosive lesion which can sometimes be missed on initial radiological examination. Surgical exploration allows collecting suspicious tissue for histological diagnosis which is important for the actual treatment. A revision endoscopic excision of a clival chordoma is challenging and has been highlighted in this report.
authors.affiliation: Department of Otorhinolaryngology, University Hospital - CHUV, Lausanne, Switzerland. kishore.sandu@hopitalvs.ch.
authors.forename: Jaber
authors.initials: J
authors.lastname: Alshammari
authors.forename: Philippe
authors.initials: P
authors.lastname: Monnier
authors.forename: Roy T
authors.initials: RT
authors.lastname: Daniel
authors.forename: Kishore
authors.initials: K
authors.lastname: Sandu