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Chordoma : Imaging

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Case History: The patient was a 50 y/o male who presented with progressive headaches, diplopia, and numbness of face. Work up revealed a mass at the clivus.

MRI with contrast (sagittal T1 image) shows a large, well-defined mass centered over the clivus. The lesion was T2 hyperintense and showed vivid, but heterogenous enhancement with post-contrast images.

The mass invaded sphenoid sinus anteriorly and pontine cistern posteriorly where it abut the basilar artery. It invaded both cavernous sinuses with encasement of left internal carotid artery (cavernous portion). See coronal T1 MRI image in the next slide. The diagnosis of clival chordoma was confirmed on histopathology. Chordomas are slow-growing but locally invasive and destructive tumors.

Case courtesy of Dr Dylan Kurda, Radiopaedia.org. From the case rID: 36795

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